Current health insurances

And to add to that, as far as I know; Caritas is also the only Medical Insurance Company that will cover pre-existing conditions, whereas other Insurance Companies will not cover any illness if it is pre-existing, so bonus points there as well...

 

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.

 

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.

 

Ooopps, sorry... CORRECTION, please...

On second look, Pacific Cross Health Care, Inc. (formerly Blue Cross Health Care, Inc.) covers seniors aged 66-100 -- in Peso plan and also in Dollar plan.

Yes, the Pacific Cross Health benefits look superior to Caritas Health Shield especially since there are more advantages and HMO benefits can be availed both in RP and overseas. Premiums cost higher though - more affordable for expats -- and local and overseas HMO benefit availment are both on reimbursement basis. I guess that is why I am focused on choosing Caritas instead - I don't like bringing cash to the hospital. Pacific Cross has no office in Dumaguete but there is an agency at Aldecoa Drive, Brix, Daro, Dumaguete City, Phone Telephone:+63 35 421-2308, E-mail:dumaguete@pacificcross.com.ph, Mobile:+63 998 964-6690; +63 917 539-1921

 

This is the one of the key things for me. If I'm paying 200 php to get 300 php of benefits, should I need them, it seems like self insuring is the way to go. One healthy year and now I'm saving money. Do insurance companies have negotiated rates like in the US, so there is the advantage of a lower cost per procedure. As an example, my wife had had an appendecotomy and the hospital cost alone was $60K USD for 1.5 days of hospitalization. The negotiated insurance rate was around $8K as I recall. Is it possible to negotiate a lower cash rates in the Philippines? Do people paying out of pocket see the same cost as insured persons?

 

AFAIK have Pacific Cross also a direct pay option called ACCESS. You pay a bit more but they reimpurse directly to the hospital. No need for money in advance.

 

And let's not forget drug coverage......how does that work?

 

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.

 

Good policy = "We cover everything but this" = what is not mentioned as not covered is included in benefit coverage

Poor policy = tells what it covers and if it is not named, it is not covered = what is not mentioned as covered is excluded from benefit coverage

Insurance is tricky indeed but thank you for the clue!

 

Which are recommended health insurances for the Philippines? Including international ones which have no citizen restriction.