Oo nga naman. Bakit di na lang kasi lahat ng hospitals at doctors accredited lahat ng HMOs. Kasi I had an experience when I needed a check up for an OB. Dahil magkaiba ang doctors, naglabo labo yung reseta sa akin. Hassle pa minsan yung policy ng mga HMOs kasi may certain doctors lang silang accredited kahit malaki naman ang limit mo.
aiai, what you are saying is one of the basic concepts of hmos. it's either your agent did not explain it to you clearly, or you did not make an effort to understand the basics. accreditation is easy. if your doctor is not accredited, then have him/her apply for accreditation - that is, if he/she is willing to do so.
Mag demanda ka nalng miss ai ai , para kaw rin mapahiya sa huli, may contract kang sinusunod, try mo magbasa. Accredited hospital nga pro si doctor hindi natanggap ng rate ng hmo sa hospital , so paano regular rate ibabayad nila sa doctor mo na non affiliated?
Oo Anon 1:09,tumpak! Mas ok ang Maxicare kc sa company ko dati Maxicare kami mas madali magpa approve and mas madami accredited doctors, nung nag cost cutting si Company nag Medicard sila, medyo nanibago kmi tpos ndi pa accredited derma ko. Hirap humanap
Ganun din naman philhealth diba? Kasi may mga hosp and doctors na hindi accredited ng philhealth. Kaya para sa akin, ipon na lang ako pera para sa health ko. Kikita pa sa banko kahit maliit lang.
1:25 Mas marami pa rin ang philhealth-accredited. Iba pa rin yung may philhealth ka kahit paano. Magkano lang naman hulog mo per month wala pang 400 kung employed ka, 600+ kung self-employed. Eh kung ma-hospital ka for a month san aabot ang 600 mo? Laking tulong din ah.
yes ms.ai...my booklet ho kayo kng sino doctor at hospital na affiliated sa hmo nyo...at doctor at hospital po kasi ngaapply sa hmo nyo para mging affiliated cla....
That is true ms. ai ai and ang masakit pa ang doctor na affiliated dyan hindi magagaling. Pinapatos na lang nila yan kasi wala silang masyadong pasyente, most doctors that are good in their field wont accept any insurance because of too much paper works that you need to submit to the insurance company
Not really. There are a lot of respected, credible, effective doctors leading in their field who are affiliated with hmos in manila. Many of them are in mmc, st. Lukes and Asian. Pero there are still a handful lang naman na Hindi, konti lang yun.
@12:23 wag mag comment kung igorante. Most of the big medical centers would require all drs in their hospital to be accredited kung anong hmo meron sila.
Si Aiai 80k lang ang coverage? Hindi siguro sis. Premium yun. Ako nga, modesty aside ha, 200k ang coverage per year/per illness so impossible na she was referring to coverage. And yes, Maxicare yung HMO ko.
Ms. Ai ganyan naman po talaga halos lahat ng healthcard. Kung sino lang po ang affiliated na doctors/hospitals sila lang po talaga. Di lang naman ang MediCard ang ganyan po. :)
Di ba pareho lang na may network of doctors ang PPO & HMO? Yung PPO nga lang will partially pay for your fees if the doctor is not within their network but it's not totally free.
i agree with Ai.. babasahin ko ba buong booklet at isasa-ulo mga policy nyo? nung na ospital ako.. katakot-takot n hanap ng ospital n affiliated ang nagnyari s akin habang sasabog n sa sakit ung apdo ko... mas ok pa tlga PhilHealth tlga lalo sa mga senior.. walang kuda.. tapos agad... kaya i also advise n wag n lng.. ipunin nyo na lang talaga.. di naman lahat ng premium nyo mama-maximize nyo every year.. at depende pa sa premium nyo ung covered lang niyang sakit.. i definitely agree with her..
Hahaha dapat naman talaga basahin mo teh lalo na kung binayaran mo. At ang magandang gawin e ilista mo sa emergency book mo yung pinakamalapit na hosp at doctor para in case may mangyari e doon ka na agad punta.
Baka benefit yung HMO from your employer kaya hindi mo na binasa yung booklet? Ako nga kahit free ang HMO ko pagkareceive ko ng booklet nung maregular ako binasa ko kaagad. Hindi naman mahirap intindihin eh. Ang maganda dyan, markahan mo na yung hospitals na accredited ng HMO mo. Yung malapit sa residence at work mo at kung sang lugar ka pa naglalagi. Mahirap ba yun? Tapos isave mo sa phone mo, isulat mo imagnet sa ref para kahit hindi mo laging dala ang booklet. Nassearch na rin yan online. Alam naman natin na mahirap maging calm pag may emergency kaya gawin natin lahat para prepared tayo when the need arises.
Maging handa. IM ready. Serbisyong totoo ng GMA. Charot haha.
True. Walang sense ang health medical cards na yan. In case of emergency, on the verge of stress, death or fainting ka na, many questions are being asked pa sa iyo about the doctor and hospital mismo.
Ikaw na nga nagbabayad, ikaw pa mamatay sa stress and kunsumisyon. Buti sana if all hospital employees are not bastos when dealing with patients. Sus!
Mas stress-free pa ang PhilHealth na medyo nag-improve na ang services.
Malaking tulong naman ang HMO, lets not downplay that unless kung kaya mo magpaluwal ng daang libo instantly. Ganon talaga may question and answer although it needs improvement pero hindi na mawawala yun.
well ang medical insurance at kahit anu pang insurance eh hindi mo ralaga maaapreciate unless nagamit mo sya sa panahong nangangailangan ka nito. parang fire insurance tingin mo sayang ang bayad pero ynless na actual kang masunugan eh saka mo sya maaapreciate.
Never naman ako nagkaproblema sa Maxicare and Intellicare, magagalang at mababait pa mga staff nila. Even Asian Life is ok. Nasubukan ko silang 3 nung nagwowork pa ako and even now na dependent ako ng anak ko
Ay nako naman Ai Ai.. ayan ka na naman sa kuda mo tulad nung sa Zonrox bottle na hndi puno. Kaloka ka! May offices sa hospital ang different HMOs, mag inquire ka kasi muna. Talagang hndi pwede na kung sino ang gusto mong doctor eh yun ang masusunod. Kailangan tlga accredited sa kanila. Thats the reason why you're also paying for the premium dahil sinisigurado sayo na may mga competent doctors and hospitals na affiliated sa kanila. getting a policy from them means pumapayag ka at satisfied sa mga kaya nilang i-cater na hospitals ang dosctors sayo. O eto bonus pa, hndi lahat ng sakit covered ng HMO mo ha. May mga certain illnesses na hndi kasama. Kaloka tong si Ai Ai pa VIP na naman!
Everytime you go to a clinic or hospital, ang una mo dapat sabihin ay Medicard ang HMO mo. Automatic yun na bibigyan ka ng doctor na affiliated as HMO mo. Malamang dumirecho lang sya na nagpaconsult at hindi nagtanong. Most big hospitals even have their own information counter for HMO card holders. Natuto pong magbasa at magtanong.
Ai ai, you're making it look like na basta basta ka lang kumukuha ng hndi iniintidi king ano binibili mo tapos magrereklamo ka ng ganyan. Wala ka bang financial adviser na pwede mag explain sayo how insurances and how to get a proper HMO that will suit your needs. Sa sinasabi mo kasi parang napabili ka lang nang hndi inaalam ng mabuti eh. So sino nga ba may kasalanan pag ganun?
With Maxicare, the professional fee of non-accredited doctors are being reimbursed through fund transfer and can be withdrawn using the card itself. I have never encountered any problem with the coverage because I am knowledgeable of the ins and outs of the plan availed.
I think Ai Ai should be informed of the true coverage of her plan so she will not be surprised why certain aspect cannot be covered. However, if she pays 80k premium, I bet if not all, most of the diseases, even the pre-existing one should be covered. Or if by 80k she means MBL per illness, then she probably availed the cheaper plan which is limited to affiliated hospitals and doctors and does not cover pre-existing conditions.
As providers, the insurance company should be straightforward in discussing the plan coverage. And as clients, it is our responsibility to scrutinize the inclusions and question whatever is unclear to us.
Had a problem with Medicard before... balik Intelicare Kami... so far ok naman Sa intelicare Wala ako naging problem. Marami doctors Sa medical city na magagaling naka intelicare. Pero miss ai Ganun talaga may booklet tayo or call your agent hawak ng account me in that way he/she can lead you Sa doctors na hinahanap mo. You are blessed nga may ganyan ka privilege yung Iba nga diyan Wala medicard at Pera pag gamot. Patulong ka na Lang
Hi! On a related note, my parents are both over 60. Are they still elligible for health insurance? And if so, how much usually ang premium? Maraming salamat. Nagtanong na ako since marami may alam about health insurance dito.
hello 9:30 there are micro insurance available if they dont accept 60 y/o my mom turned 60 and was removed as my dependent good thing may prepaid microinsurance very helpful
Hello 12:36! Thank you for responding. First time ko marinig ang microinsurance. Microfinance lang ang alam ko. Sino usually ang nag-ooffer ng mga microinsurance? May pwede ka bang i-recommend? Salamat.
Di ba rich ka? Sa yaman mong yan jan ka lang sa MediCard kumuha ng HMO? Sana inaalam mo kasi kung ano yung mga best providers para dun mo na lang nilaan ang pera mo. Sino ba nagsabi sayo na jan kasi kumuha ng medical insurance?
Kailangn affiliated ang doktor sa hospital para sa quality assurance. Mahirap naman sa hospital na pagamit ang premises nila not knowing kung gaano ka competent ang doktor. It is also to cover them for lawsuit. The trick is to find a doctor you feel comfortable with and ask them if they can see patient in the hospital you like. Easy peasy!
totoo yan, ako natapos na magclinic ang doctor di pa sumasagot ang MEDICARD. Nnung sumgot na parta may number na LOA ko, lumipat pako ng ibang hspiutal para sundan ung doctor]!!!!
Ganyan naman talaga policy ng insurance. Hindi ba sya nagtanong sa doctor nya before sya kumuha ng insurance kung affliated yun? Tsaka maliit ang 80t. Pang dependants lang yun sa insurance na ginagamit namin. Hanap nalang ng iba.
i think hindi nya rin alam ang tamang proseso, kahit anong HMO naman, kukuha ka muna ng LOA sa HMO concierge before consultation. malamang straight siya sa doctor w/o even checking sa door kung may nakalagay na maxicare
Ganyan talaga ang medicard. We used to have maxicare pero ewan kung ano pinakain ng tga medicard sa employees union namin at ilang taon na kmig medicard despite of the many complaints regarding their services. Maraming beses na hindi ko na ginagamit ang medicard because nako cover na ng philhealth at senior citizen discount ng mother ko. Kudos to philhealth talaga, ang laking tulong nila esp for senior citizen patients.
Maxicare is really good. Hindi yata naexplain kay madam na kelangan affiliated ang doctor at hospital. Yan ang dapat na una mong itatanong. Pero mahirap nga naman pag emergency. Kasi wala ka ng choice, basta makarating ka lng dun sa pinakamalapit.
dapat kahit di affiliated reimburse nila yung doctor's fee.. it doesn't mean dapat n di mo magagamiy yung card at all.. if affiliated yung doctor mas convenient lng pagbabayad. i think yung 80k ay bayaf nya per year.
Dapat inalam mo muna bago ka kumuha ng policy. Aba hindi biro magbayad ng premium ha kaya dapat informed ka, anong covered at anong tamang proseso at requisites para ma-avail mo yung benefits. Pati dependents and guardian mo dapat alam. Basahin mo yung booklet.
No choice ako kasi Intellicare ang HMO ng employer ko but so far wala namang naging problem. Sa reception pa lang tatanungin ka na kung may healthcard. Ganon talaga.
ms. ai-ai punta ka muna kasi sa HMO office mg ospital sila ang magsasabi sa iyo kung kanino ka pwede pumunta na doctor! juicecolored basa basa din muna ng process pag may time. kaliliit na bagay yan! if emergency naman eh hindi kailangan dumaan sa HMO at kahit hindi accredited eh marefund ka naman.
BEFORE YOU GET ANYTHING, YOU NEED TO KNOW EVERYTHING...BEFORE IMBYERNA DIN AKO CAN'T UNDERSTAND THE PROCESS, PERO LATER ON, NA ABSORB NA DIN AT NA GETS NA...JUST LAST MONTH, WE USED THE MEDICARD NA HOSPITALIZED ANG HUSBAND AND HE DID NOT PAY ANY SINGLE CENTAVO. MEDICARD PEOPLE HELPED IN PROCESSING HIS HOSPITAL CONCERNS.
sa kanya since self employed sya at malaki naman kita nya mas ok na magipon nalang sya, dun sa mga employed na walang pambayad ng insurance malaking bagay din yan.
"most of the time hindi yan alam ng client kapag nagbebenta sila ng insurance" --> kahit ano pa ang ibenta sa inyo, hindi mo ka dapat o-oo agad or magbabayad agad. do your own research first, ms. ai bago ibigay ang inyong hard earned money. just saying.
Madam Aiai, ganyan po talaga ang nature ng HMO. Now, if you actually bought medical/health insurance coverage, and may provision sya for reimbursement with non accredited doctors, eh di sana hindi mo naging issue yan. Sana din po iniintindi nyo ang policy provisions beforehand. Sa laki ng premium na binayaran mo, you could have gotten better coverage elsewhere. I know this for a fact dahil I work in the medical insurance industry (not medicard though).
Ms ai ai para hindi ka na mahirapan sa medicard mag cash ka na lang. Dapat talaga accredited ng medicard ang dr mo para hindi ka na magbayad ng pf kasi covered na un ng hmo
Our health insurance here in Thailand pays for everything as long as it is covered. If the doctor or hospital is not affiliated, we just have to pay cash but the insurance company refunds to us no questions asked. Like I said, as long as it is part of insurance coverage. Even if we get hospitalized in Manila we just show the receipts and the prescription and medical certificate from dr or hospital, our insurance company pays for it.
Unfortunately, that's how it goes..
ReplyDeletekaya nga me health cards na mga ganyan dahil me mga affiliations...kasi kung walang health card e Universal Free Medical Health yun
DeleteOo nga naman. Bakit di na lang kasi lahat ng hospitals at doctors accredited lahat ng HMOs. Kasi I had an experience when I needed a check up for an OB. Dahil magkaiba ang doctors, naglabo labo yung reseta sa akin. Hassle pa minsan yung policy ng mga HMOs kasi may certain doctors lang silang accredited kahit malaki naman ang limit mo.
Deleteaiai, what you are saying is one of the basic concepts of hmos. it's either your agent did not explain it to you clearly, or you did not make an effort to understand the basics. accreditation is easy. if your doctor is not accredited, then have him/her apply for accreditation - that is, if he/she is willing to do so.
Delete7:03 eh di stress nga ang aabutin mo. Biruin mo may sakit ka na nga mangungumbinsi ka pa ng doktor. Kaloka.
Deleteanon 7:03 or, hindi nya binasa yung policy (basta nilagay na lang sa filing cabinet ba) dahil meron return policy if you are not agreeable sa terms
DeleteOkay. sa comments below, nalaman ko na better ang maxicare kesa medicard. TY po!
DeleteMag demanda ka nalng miss ai ai , para kaw rin mapahiya sa huli, may contract kang sinusunod, try mo magbasa. Accredited hospital nga pro si doctor hindi natanggap ng rate ng hmo sa hospital , so paano regular rate ibabayad nila sa doctor mo na non affiliated?
DeleteOo Anon 1:09,tumpak! Mas ok ang Maxicare kc sa company ko dati Maxicare kami mas madali magpa approve and mas madami accredited doctors, nung nag cost cutting si Company nag Medicard sila, medyo nanibago kmi tpos ndi pa accredited derma ko. Hirap humanap
DeleteGanun nmn tlga miss Ai dapat affiliated tlga , kya bago k kumuha dpat inalam mo
ReplyDeleteGanun din naman philhealth diba? Kasi may mga hosp and doctors na hindi accredited ng philhealth. Kaya para sa akin, ipon na lang ako pera para sa health ko. Kikita pa sa banko kahit maliit lang.
Delete1:25 Mas marami pa rin ang philhealth-accredited. Iba pa rin yung may philhealth ka kahit paano. Magkano lang naman hulog mo per month wala pang 400 kung employed ka, 600+ kung self-employed. Eh kung ma-hospital ka for a month san aabot ang 600 mo? Laking tulong din ah.
Deleteyes ms.ai...my booklet ho kayo kng sino doctor at hospital na affiliated sa hmo nyo...at doctor at hospital po kasi ngaapply sa hmo nyo para mging affiliated cla....
ReplyDeletetrue bes, may medicard din ako dati, may kasama talaga siyang list ng hospital/clinics
Deleteung iba kasi porket my insurance nabili na nila ung hospital
DeleteOA mo 1:15. Saan ka naman nakakita ng ganyan? Mostly hospital pa ang maangas lalo na kung wala kang pera di ka papasukin kahit naghihingalo k na.
Delete1:15
Deleteang oa mo nga
That is true ms. ai ai and ang masakit pa ang doctor na affiliated dyan hindi magagaling. Pinapatos na lang nila yan kasi wala silang masyadong pasyente, most doctors that are good in their field wont accept any insurance because of too much paper works that you need to submit to the insurance company
ReplyDeleteDISAGREE! Ung doctor ko under cia ng medicard, maxicare, etc pero isa ciang kilalang Doctor ilan beses na rin na-feature sa TV.
DeleteI second emotion disagree din! Yung doctor tatay ko ang galing ang bait affliated ng medicard
DeleteEmotion talaga baks? Sana nagjojoke ka lang. Wahaha!
Deletethis is so not true. my ob is accredited hmo and she is really good. mas gusto nga nila yan kasi sure paid sila.
DeleteWho are you to judge doctors credibility???
DeleteNot really. There are a lot of respected, credible, effective doctors leading in their field who are affiliated with hmos in manila. Many of them are in mmc, st. Lukes and Asian. Pero there are still a handful lang naman na Hindi, konti lang yun.
Delete@12:23 wag mag comment kung igorante. Most of the big medical centers would require all drs in their hospital to be accredited kung anong hmo meron sila.
Delete@11:42 AM - emotion???
Delete80k na premium? Ang mahal naman nun. Baka coverage yung 80k. Anyways, kuha na lang sya ng maxicare. Mas convenient.
ReplyDeleteMaxicare is the best HMO for me. Ang baba ng coverage nya pala.
DeleteSi Aiai 80k lang ang coverage? Hindi siguro sis. Premium yun. Ako nga, modesty aside ha, 200k ang coverage per year/per illness so impossible na she was referring to coverage. And yes, Maxicare yung HMO ko.
DeletePwede ang 80k na premium kung malaki ang coverage besides baka kasama dependents sa binabayaran niya
Delete80K i think thats for individual account lang
Delete80k is possible if you're alone, compared sa companies na kayang i-haggle na lower premium kasi mas maraming principal members.
DeleteMay pt sya, pahirapan talaga ang Medicard.
ReplyDeleteTama kainis mga health cards na yan, ipunin nyo nlang pera.
ReplyDeleteYan ang hirap pag vip ang patiente. Need mo talaga sumunod dun sa booklet. Unlike pag ordinaryong employee ka lang walang kahirap hirap
ReplyDeleteMs. Ai ganyan naman po talaga halos lahat ng healthcard. Kung sino lang po ang affiliated na doctors/hospitals sila lang po talaga. Di lang naman ang MediCard ang ganyan po. :)
ReplyDeleteThere's a huge difference between HMO and PPO. I think she is looking for the PPO characteristics.
ReplyDeleteDi ba pareho lang na may network of doctors ang PPO & HMO? Yung PPO nga lang will partially pay for your fees if the doctor is not within their network but it's not totally free.
Deletei agree with Ai.. babasahin ko ba buong booklet at isasa-ulo mga policy nyo? nung na ospital ako.. katakot-takot n hanap ng ospital n affiliated ang nagnyari s akin habang sasabog n sa sakit ung apdo ko... mas ok pa tlga PhilHealth tlga lalo sa mga senior.. walang kuda.. tapos agad... kaya i also advise n wag n lng.. ipunin nyo na lang talaga.. di naman lahat ng premium nyo mama-maximize nyo every year.. at depende pa sa premium nyo ung covered lang niyang sakit.. i definitely agree with her..
ReplyDeleteBasahin mo talaga bakz habang wala ka pang sakit. Wag syongz. Ok?
Deletete lahat ng bagay na bago mo pirmahan binabasa dapat. may kontrata yan or policy na tinatawag. kaloka ka.
Deleteand yes kung may sakit ka at emergency they would ask if you have hmo so they give you the accredited doctor in their hospital. its how it works.
DeleteHahaha dapat naman talaga basahin mo teh lalo na kung binayaran mo. At ang magandang gawin e ilista mo sa emergency book mo yung pinakamalapit na hosp at doctor para in case may mangyari e doon ka na agad punta.
DeleteBaka benefit yung HMO from your employer kaya hindi mo na binasa yung booklet? Ako nga kahit free ang HMO ko pagkareceive ko ng booklet nung maregular ako binasa ko kaagad. Hindi naman mahirap intindihin eh. Ang maganda dyan, markahan mo na yung hospitals na accredited ng HMO mo. Yung malapit sa residence at work mo at kung sang lugar ka pa naglalagi. Mahirap ba yun? Tapos isave mo sa phone mo, isulat mo imagnet sa ref para kahit hindi mo laging dala ang booklet. Nassearch na rin yan online. Alam naman natin na mahirap maging calm pag may emergency kaya gawin natin lahat para prepared tayo when the need arises.
DeleteMaging handa. IM ready. Serbisyong totoo ng GMA. Charot haha.
Mas okay nga yung Maxicare kasi parang mas malaki ang network nila ng doctors and hospitals.
ReplyDeleteTrue. Walang sense ang health medical cards na yan. In case of emergency, on the verge of stress, death or fainting ka na, many questions are being asked pa sa iyo about the doctor and hospital mismo.
ReplyDeleteIkaw na nga nagbabayad, ikaw pa mamatay sa stress and kunsumisyon. Buti sana if all hospital employees are not bastos when dealing with patients. Sus!
Mas stress-free pa ang PhilHealth na medyo nag-improve na ang services.
You will still need an HMO kahit may PhilHealth. Maliit lang ang % na sinasagot ng PhilHealth sa total billing noh!
DeleteGets ko si 12:58. Basahin mo ulit 2:54. Kelan pa naging 'need' ang hmo? Dun ka siguro nagwwork
DeleteMalaking tulong naman ang HMO, lets not downplay that unless kung kaya mo magpaluwal ng daang libo instantly. Ganon talaga may question and answer although it needs improvement pero hindi na mawawala yun.
Deletewell ang medical insurance at kahit anu pang insurance eh hindi mo ralaga maaapreciate unless nagamit mo sya sa panahong nangangailangan ka nito. parang fire insurance tingin mo sayang ang bayad pero ynless na actual kang masunugan eh saka mo sya maaapreciate.
Deleteyou can count on me🎶 - Medicard
ReplyDeleteNever naman ako nagkaproblema sa Maxicare and Intellicare, magagalang at mababait pa mga staff nila. Even Asian Life is ok. Nasubukan ko silang 3 nung nagwowork pa ako and even now na dependent ako ng anak ko
ReplyDeleteMaxicare din kami at true mabait staffs nila. Twice na nga nilang inaadjust bills namin sa hospital para hindi na kami magbabayad ng excess.
Deleteako medicard before nagpalit aq ng maxicare kz mas maraming covered na doctor at hospital sa maxicare
ReplyDeleteAy nako naman Ai Ai.. ayan ka na naman sa kuda mo tulad nung sa Zonrox bottle na hndi puno. Kaloka ka! May offices sa hospital ang different HMOs, mag inquire ka kasi muna. Talagang hndi pwede na kung sino ang gusto mong doctor eh yun ang masusunod. Kailangan tlga accredited sa kanila. Thats the reason why you're also paying for the premium dahil sinisigurado sayo na may mga competent doctors and hospitals na affiliated sa kanila. getting a policy from them means pumapayag ka at satisfied sa mga kaya nilang i-cater na hospitals ang dosctors sayo. O eto bonus pa, hndi lahat ng sakit covered ng HMO mo ha. May mga certain illnesses na hndi kasama. Kaloka tong si Ai Ai pa VIP na naman!
ReplyDeleteEverytime you go to a clinic or hospital, ang una mo dapat sabihin ay Medicard ang HMO mo. Automatic yun na bibigyan ka ng doctor na affiliated as HMO mo. Malamang dumirecho lang sya na nagpaconsult at hindi nagtanong. Most big hospitals even have their own information counter for HMO card holders. Natuto pong magbasa at magtanong.
ReplyDeleteAi ai, you're making it look like na basta basta ka lang kumukuha ng hndi iniintidi king ano binibili mo tapos magrereklamo ka ng ganyan. Wala ka bang financial adviser na pwede mag explain sayo how insurances and how to get a proper HMO that will suit your needs. Sa sinasabi mo kasi parang napabili ka lang nang hndi inaalam ng mabuti eh. So sino nga ba may kasalanan pag ganun?
ReplyDeletenaalala ko kuda sa zonrox. napautot ako kakatawa sa inis.
DeleteWith Maxicare, the professional fee of non-accredited doctors are being reimbursed through fund transfer and can be withdrawn using the card itself. I have never encountered any problem with the coverage because I am knowledgeable of the ins and outs of the plan availed.
ReplyDeleteI think Ai Ai should be informed of the true coverage of her plan so she will not be surprised why certain aspect cannot be covered. However, if she pays 80k premium, I bet if not all, most of the diseases, even the pre-existing one should be covered. Or if by 80k she means MBL per illness, then she probably availed the cheaper plan which is limited to affiliated hospitals and doctors and does not cover pre-existing conditions.
As providers, the insurance company should be straightforward in discussing the plan coverage. And as clients, it is our responsibility to scrutinize the inclusions and question whatever is unclear to us.
nailed it! HR ka no? joke!
DeleteHaha nasa HR to nag hahandle ng health policy ng employees. Good job ate sa napaka linaw na explaination.
DeleteHad a problem with Medicard before... balik Intelicare Kami... so far ok naman Sa intelicare Wala ako naging problem. Marami doctors Sa medical city na magagaling naka intelicare. Pero miss ai Ganun talaga may booklet tayo or call your agent hawak ng account me in that way he/she can lead you Sa doctors na hinahanap mo. You are blessed nga may ganyan ka privilege yung Iba nga diyan Wala medicard at Pera pag gamot. Patulong ka na Lang
ReplyDeleteIntellicare maganda? Try mo Maxicare and you will never go back to Intellicare.
DeleteIntellicare no longer caters to personal accounts. They only have corporate accounts. For personal accounts its Maxi, Medi or Cocolife
DeleteHi! On a related note, my parents are both over 60. Are they still elligible for health insurance? And if so, how much usually ang premium? Maraming salamat. Nagtanong na ako since marami may alam about health insurance dito.
Deletehello 9:30 there are micro insurance available if they dont accept 60 y/o my mom turned 60 and was removed as my dependent good thing may prepaid microinsurance very helpful
DeleteHello 12:36! Thank you for responding. First time ko marinig ang microinsurance. Microfinance lang ang alam ko. Sino usually ang nag-ooffer ng mga microinsurance? May pwede ka bang i-recommend? Salamat.
DeleteDi ba rich ka? Sa yaman mong yan jan ka lang sa MediCard kumuha ng HMO? Sana inaalam mo kasi kung ano yung mga best providers para dun mo na lang nilaan ang pera mo. Sino ba nagsabi sayo na jan kasi kumuha ng medical insurance?
ReplyDeleteHindi siguro para sa kanya.
DeletePang low income ba ang medicard? char
DeleteKailangn affiliated ang doktor sa hospital para sa quality assurance. Mahirap naman sa hospital na pagamit ang premises nila not knowing kung gaano ka competent ang doktor. It is also to cover them for lawsuit. The trick is to find a doctor you feel comfortable with and ask them if they can see patient in the hospital you like. Easy peasy!
ReplyDeletetotoo yan, ako natapos na magclinic ang doctor di pa sumasagot ang MEDICARD. Nnung sumgot na parta may number na LOA ko, lumipat pako ng ibang hspiutal para sundan ung doctor]!!!!
ReplyDeleteGanyan naman talaga policy ng insurance. Hindi ba sya nagtanong sa doctor nya before sya kumuha ng insurance kung affliated yun? Tsaka maliit ang 80t. Pang dependants lang yun sa insurance na ginagamit namin. Hanap nalang ng iba.
ReplyDeletenasa policy kaya yan na dapat affiliated yung doctor at hospital. Di nya lang binasa nuon tapos panay reklamo ngayon
ReplyDeleteMs. Ai, pakibasa po kasi yung booklet na kasama ng card mo.
ReplyDeletei think hindi nya rin alam ang tamang proseso, kahit anong HMO naman, kukuha ka muna ng LOA sa HMO concierge before consultation. malamang straight siya sa doctor w/o even checking sa door kung may nakalagay na maxicare
ReplyDeleteGanyan talaga ang medicard. We used to have maxicare pero ewan kung ano pinakain ng tga medicard sa employees union namin at ilang taon na kmig medicard despite of the many complaints regarding their services. Maraming beses na hindi ko na ginagamit ang medicard because nako cover na ng philhealth at senior citizen discount ng mother ko. Kudos to philhealth talaga, ang laking tulong nila esp for senior citizen patients.
ReplyDeleteMaxicare is really good. Hindi yata naexplain kay madam na kelangan affiliated ang doctor at hospital. Yan ang dapat na una mong itatanong. Pero mahirap nga naman pag emergency. Kasi wala ka ng choice, basta makarating ka lng dun sa pinakamalapit.
ReplyDeletedapat kahit di affiliated reimburse nila yung doctor's fee.. it doesn't mean dapat n di mo magagamiy yung card at all.. if affiliated yung doctor mas convenient lng pagbabayad. i think yung 80k ay bayaf nya per year.
ReplyDeleteDapat inalam mo muna bago ka kumuha ng policy. Aba hindi biro magbayad ng premium ha kaya dapat informed ka, anong covered at anong tamang proseso at requisites para ma-avail mo yung benefits. Pati dependents and guardian mo dapat alam. Basahin mo yung booklet.
ReplyDeleteNo choice ako kasi Intellicare ang HMO ng employer ko but so far wala namang naging problem. Sa reception pa lang tatanungin ka na kung may healthcard. Ganon talaga.
ms. ai-ai punta ka muna kasi sa HMO office mg ospital sila ang magsasabi sa iyo kung kanino ka pwede pumunta na doctor! juicecolored basa basa din muna ng process pag may time. kaliliit na bagay yan! if emergency naman eh hindi kailangan dumaan sa HMO at kahit hindi accredited eh marefund ka naman.
ReplyDeleteSa tingin niyo pag emergency may panahon pa sila magbasa ng booklet???
DeleteBEFORE YOU GET ANYTHING, YOU NEED TO KNOW EVERYTHING...BEFORE IMBYERNA DIN AKO CAN'T UNDERSTAND THE PROCESS, PERO LATER ON, NA ABSORB NA DIN AT NA GETS NA...JUST LAST MONTH, WE USED THE MEDICARD NA HOSPITALIZED ANG HUSBAND AND HE DID NOT PAY ANY SINGLE CENTAVO. MEDICARD PEOPLE HELPED IN PROCESSING HIS HOSPITAL CONCERNS.
Deleteanon 9:22, paki basa last sentence ni anon 7:45.
DeleteFyi. Hindi po er case yung kay ms. Aiai
Deletesa kanya since self employed sya at malaki naman kita nya mas ok na magipon nalang sya, dun sa mga employed na walang pambayad ng insurance malaking bagay din yan.
ReplyDelete"most of the time hindi yan alam ng client kapag nagbebenta sila ng insurance" --> kahit ano pa ang ibenta sa inyo, hindi mo ka dapat o-oo agad or magbabayad agad. do your own research first, ms. ai bago ibigay ang inyong hard earned money. just saying.
ReplyDeleteang tagal ko ng member ng medicard pati mga dependents ko. so far wala naman kami naging problema. gamit na gamit din ang medicard benefits sa amin.
ReplyDeletecheck mo ms. ai ai ang website. malaking tulong mga info na makikita mo doon.
Madam Aiai, ganyan po talaga ang nature ng HMO. Now, if you actually bought medical/health insurance coverage, and may provision sya for reimbursement with non accredited doctors, eh di sana hindi mo naging issue yan. Sana din po iniintindi nyo ang policy provisions beforehand. Sa laki ng premium na binayaran mo, you could have gotten better coverage elsewhere. I know this for a fact dahil I work in the medical insurance industry (not medicard though).
ReplyDeleteMs ai ai para hindi ka na mahirapan sa medicard mag cash ka na lang. Dapat talaga accredited ng medicard ang dr mo para hindi ka na magbayad ng pf kasi covered na un ng hmo
ReplyDeleteOur health insurance here in Thailand pays for everything as long as it is covered. If the doctor or hospital is not affiliated, we just have to pay cash but the insurance company refunds to us no questions asked. Like I said, as long as it is part of insurance coverage. Even if we get hospitalized in Manila we just show the receipts and the prescription and medical certificate from dr or hospital, our insurance company pays for it.
ReplyDeleteIba po ang insurance sa HMO ma'am
DeleteHealth Insurance is different from HMO. Even in Singapore. HMO has accredited Doctors, Clinics at Hospitals.
DeleteAffiliated doctors and hospitals talaga ang mga hmos. Either it was explained to you or you didnt pay attention at all
ReplyDeleteHmmmmm
ReplyDeleteKailangan talaga ng accredition kahit naman sa ibang bansa ganyan ang patakaran.
ReplyDeletePwede pa rin naman siyang magpagamot sa non-accredited doctors at hospitals. Then, i-reimburse na lang nya. May limit nga lang nasa 80% lang yata.
Sinasabi naman agad yan. May binibigay na booklet ang mga health card companies na nandoon ang mga accredited doctors at hospitals..
alams na alams ng lahat mga call center agent yata kau..na umaasa sa healthcard nio..hahahah
ReplyDelete