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Current health insurances

Discussion in 'Expat Section' started by Sans Souci, Feb 3, 2016.

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  1. Brian Oinks

    Brian Oinks That's Mr. Pig to you Boy! :) Highly Rated Poster

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    I have posted this I think on another thread but will post again here in case you have not yet read it;

    A Post I received in my Facebook, which I had to read twice as it seems to be somewhat cryptic, and then Google what I think are *hidden hints at gaining Full Cover under Philhealth for Foreigners... He also mentions the Z Package which I assumed was now off the cards for Foreigners, but....

    One statement he made in regards to the operation he had done here in the Philippines;
    *If you do it at the government hospital, then it is possible to get the PhilHealth Z Package. The Z Package is available for very major health issues that are very expensive.

    POST:
    Healthcare: Can the Philippines Help?

    Healthcare: Can the Philippines Help?

    He talks about being a part of the Informal Economy;
    QUOTE:
    Currently, there is a lot of talk, lots of rumors and changes for foreigner coverage under PhilHealth. Let me just say that there are ways that foreigners can get full coverage and even at the old price. Any foreigner can get PhilHealth coverage that does not include the Z Package, and the cost is P17,000 per year. *That is for foreigners who are part of the informal economy. If you have a job or employment of another type in the Philippines there are more options available to you.

    FAST FACTS:
    What you need to know about PH's informal sector workers:
    Informal economy in the Philippines (CO-Manila)

    Informal economy in the Philippines (ILO in the Philippines)

    TO ADD TO THAT:
    Who are the Members in the Informal Economy?
    QUOTE:
    Citizens of other countries working and/or residing in the Philippines - foreign citizens with valid working permits and/or Alien Certificate of Registrations (ACRs), working and/or residing in the Philippines

    Qualified Members for the Informal Economy | PhilHealth

    Qualified Members for the Informal Economy | PhilHealth

    .................................................................................................

    I looked this up a while back for another guy on a Forum;

    Caritas Health Shield Inc.

    Clinica Caritas

    For those with preexisting conditions I noticed the following;


    Expanded PRIME Plus Healthcare Program


    A value for money plan which extends sufficient health cover for the insured and family members and also protects from premium increases over a 5 year pay plan. With a guaranteed 5% increment from the 7th or 11th year onwards, this affordable scheme covers preexisting illnesses and provides additional health benefits during the expanded period of coverage.


    Caritas Health Shield Insurance Premium and Coverage


    Caritas Health Shield Insurance Premium and Coverage

    This is their PRODUCTS PACKAGE:

    (Fill in to obtain a quote) But I did notice that the products mentioned in the above link do not match up in namesake with this following link...

    Caritas Health Shield, Inc. Proposal

    https://www.caritashealthshield.com.ph/proposal/

    Contract Price I assume is how much it is for 2 Years. (If you pay 2x Annual payments of 147,790 php)

    CONTRACT PRICE 295,580 php

    Paying Cash in Advance (NO Monthly payments) you pay 2 Years in advance. (being the minimum time agreement for this plan)

    SPOT CASH 266,222 php

    If you pay Yearly for 2 Years.

    ANNUAL 147,790 php

    If you pay every 6 months for 2 Years.

    SEMI-ANNUAL 79,810 php

    If you pay every 3 months for 2 Years.

    QUARTERLY 41,385 php

    So the incentive is to pay in advance, you get a bonus saving of 29,358 php

    That is how I read into it not including the footnote;

    *Except for Spot Cash, add P200 Policy Fee on first payment.

    IF I avail full coverage with what options are available I assume this is how it works;

    Brian's Benefits;

    Medical Expense Benefits for 3 years 540,000

    Membership Privileges:

    Out Patient 75,780

    APE 14,850

    Preventive Healthcare 6,500

    Dental Care 8,400

    Dependents Consult 6,000

    Total Membership Privileges for 3 years 111,530

    * Total Benefits for 3 years 651,530

    All for a Total Contract Price of only 295,580

    Sounds like if I pay for TWO Years in Advance I get 3 Years of cover…
     
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  2. cabb

    cabb DI Forum Patron Highly Rated Poster ✤Forum Sponsor✤

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    Sounds like you get about a maximum 2x benefit over your premium. This doesn't sound very good to me. In the US, you might pay $10000, but your maximum benefit could be something like $1M maximum, a 100x premium to benefit ratio.
     
  3. Plainspoken

    Plainspoken DI Forum Adept

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    I don't know how much insurance experience you have, but some companies like to make you jump threw hoops with lifestyle surveys and nurse calls and stuff like that. Cigna is one. I had them. If you can tolerate the BS then you may like them. United does the same thing but are not as bad. I have their best F plan and pay no deductible, no copay, and they will pay "overcharges", charges that are higher than the average in the area for the same procedure. I've been caught in that trap a few times over the years. They also pay 60% outside the US. I pay 203.00 . I am assuming you have Medicare A and B and are talking about single coverage. It is through AARP. Whatever you do, DO NOT by an Advantage Plan. The companies are pushing those and Medicare is encouraging it. They want to go to all Advantage Plans in a few years if they can convince people to do it. I had one for one month and it was a nightmare. I raised so much hell that they allowed me to move to the plan I have now even though it was not during the "enrollment period".
     
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  4. NYC

    NYC DI Senior Member Showcase Reviewer Blood Donor Veteran Air Force

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    Through AARP I got a United Health Advantge Plan. My monthly premium is $0. Why would I do anything else if I am living full-time in the Philippines and can't use the benefit in the Philippines anyway? Zero premium to cover the zero Medicare I get here. With my spouse's (still working in the US) income combined with my pension, my traditional Medicare Plan B would have been $200-300/ month. I'll take the $0 Advantage Plan, thank you. If something goes seriously wrong and I end up back in the US for health reasons, my plan seems fairly decent and I kept my primary care doctor.

    I signed up for PhilHealth when I first arrived and it lapsed in the fall while I was visiting the US. When I returned in January, I was prepared (by postings here) for an exhorbitant rate hike. The PhilHealth clerk at Robinson looked at my card and said, "Yes, sir. You can renew now and you keep the same rate." PHP2400 per year. She said it goes into effect the following month, i.e. February. My card says I am on the "informal Economy." I get a pension, I have no job here, nor do I have any business income. She could not have mistaken me for a Filipino....I look like I belong at the bar at Flip Flops. Why did I get the same rate as last year?
     
  5. mokum

    mokum DI Senior Member

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    {Why did I get the same rate as last year?}
    Bcs you're lucky. Don't question a windfall in the PH, there are
    not so many.
     
  6. NYC

    NYC DI Senior Member Showcase Reviewer Blood Donor Veteran Air Force

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    Very true. But given the level of incompetence, I don't want to need the PhilHealth and have them say: "Sorry, sir. You paid the wrong amount for a long nose and you are not covered."
     
  7. Mom Miriam

    Mom Miriam DI Member

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    Yip, it is one among 25 Insurance Commission-accredited HMOs for 2017-2019 (Pres Pinoy had transferred regulatory supervision of HMOs from DOH to IC on May 12, 2015). It changed name from Blue Cross Health Care, lnc. to Pacific Cross Health Care, lnc. effective January 1, 2016.
     
  8. Mom Miriam

    Mom Miriam DI Member

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    My younger son married, and so I got bumped off corporate HMO coverage as employee dependent last year. To have a separate plan of my own, in addition to free PhilHealth coverage for Filipino seniors, I surveyed these 25 IC-accredited HMOs and discovered that most HMOs in RP offer coverage only for aged <60 or <65 years old. In RP, Caritas Health Shield, Inc. is the only HMO offering coverage for ages 7 to <71 years old.

    So I called them this morning to verify manner of availment - it is cashless, not reimbursement basis - which can be very convenient when you're sick and can barely PIN your ATM or safely carry sizeable cash.

    It appears that, starting this year, I will be on Caritas Shield coverage - either MAX Health Care Program for 7 to < 66 years old, Supreme Health Care Program for 7 to < 66 years old, or Enhanced Core 6 Health Care Program for 7 to <71 years old. If it adds any quality assurance, Caritas Shield was a Reader's Digest Trusted Brand awardee in 2016.
     
    • Informative Informative x 3
    Last edited: Feb 12, 2018
  9. Dr. Shiva

    Dr. Shiva DI Senior Member

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    Means this that there is no health insurance/HMO available for people 71+?
     
  10. Mom Miriam

    Mom Miriam DI Member

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    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
     
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    Last edited: Feb 12, 2018
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