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Author Topic: An alternative to HMOs/Health Cards that I have been practicing myself  (Read 3287 times)

Offline mjtfernandez

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  • Mark Fernandez, CPA, MDRT, RFC
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Hi guys, I will be sharing something that I have been doing as an alternative to buying Health Cards or HMOs.

You see, I understand the value of health risks and it's ability to erode my savings. In fact, in the profession that I have been in, I hear many sad stories of how medical problems crippled businessmen.

Although most individuals would most likely go for an HMO because it has the following benefits:
1. No cash outlay when rushed to the hospital
2. Hospital bills are covered up to a Limit say, P100,000 per illness per year
3. If you need to have a consultation, it is covered - including specialist consultation and laboratories
4. Annual APE is included

I was planning on buying an HMO yet it occurred to me the following:
1. A officemate of mine has a husband who got a heart attack. The HMO took care of the bills but eventually did not cover the heart attack operation as it was considered a dreaded disease. Thus, they had a problem where to get the money to pay for the heart bypass.
2. If I did not get sick for that year, my P14,000 would be... say... TY...
3. If I reach age 65, I will not be anymore covered by the HMO, the years after this are usually the years where you get sick

So here is how I did it:
1. I got for myself an I-HEAL insurance (health insurance from Insular Life) which provides the following benefits:
    P4,000 per day (fixed irregardless of cost of room) of hospitalization or P8,000 if ICU (to cover for room and board)
    Up to P10,000 for medicines during confinement and 2 weeks from confinement
    Up to P20,000 for doctor's fees
    Up to P50,000 for surgery

    Basically what I did is to insure that I will be covered if I get confined however, the problem is the initial cash outlay. Two things I did for this:
    a. I established at least 6 months of my monthly expense as liquid asset (savings in the bank)
    b. I keep my credit card handy and with a clean balance just in case

    Actually, the good thing about the I-Heal is that it covers per illness every 6 month. Say I got sick and confined for pneumonia, I can still be covered after 6 months when normally an HMO will have a limit of let us say P100,000 per illness per year. So, you need to wait for 12 months before the P100,000 limit gets refilled.

    Also with the I-HEAL, I chose the 20 year program in which I contribute P21,000 a year for 20 years. If ever I finish paying the 20 year program, I get all future premiums from the 21st year until I reach age 80 for free (whereas HMOs cover until age 65)!
    In my case since I am age 22, I will stop contributing age 42. When I have paid the premiums in full for 20 years, I will have my premiums for age 43 to 80 (that is 37 years) for free!

More than that, all my premiums paid at age 80 will be returned to me plus interest!

2. Now the problem for outpatient consultation. I got for myself a privilege card to cover for outpatient consultation. At P1,200 per year, here are the following benefits:

The Privilege Card of XXX Medical Company (I won't name the company because I am not related with the company)
Cardholders enjoy annual outpatient healthcare coverage for LESS. No age limit or pre-acceptance medical examinations are required. Can be used at any branch near you.

The regular Privilege Card entitles members to the following privileges:

One year coverage
-FREE UNLIMITED consultation with Healthway’s in-house Primary Care Physicians and Dentists
-FREE (1) Annual Physical Exam:
    Full medical exam
    Complete blood count
    Urinalysis
    Fecalysis
    Chest x-ray
-Fixed consultation fee of Php 400.00 with specialists (except neurologist)
-15% discount on laboratory, diagnostic, dental procedures (except orthodontics and aesthetic services), all rehab    
   modalities and use of operating room for minor surgical procedures.
-Accidental Death and Disability Insurance worth Php 100,000 from COCOLIFE (covers 5-65 years old).

Just lately I had an injury with my wrist, because of the privilege card, I had free consultation with the Physician and had my x-rays for a cheaper price.

Conclusion: As you see, I just contribute P22,200 a year and I am covered for outpatient consultation, in-patient and emergency services. More than that, my coverage is up to age 80. All I have to do is to contribute in full the 20 year program and the remaining premiums from the 21st year until I reach age 80 is free. Also, when I reach age 80, all my premiums will be returned plus a small interest.

Something that makes my program much better:
As you see, one of the disadvantages of an HMO/Health Card is that it does not cover for dreaded diseases like cancer, heart attack, stroke, kidney failure, and other dreaded diseases. With my program, I am provided P1.5M in case I get diagnosed of any of the dreaded disease. Actually, I got this rider because I heard of someone who had a dreaded disease who got a large lump sum. They were able to pay the hospital bills and the rest of the money they used to travel in Europe!

What will happen to me after I reach the age of 80:
I thought about it, the return of premiums plus minimal interest from I-HEAL will be given to me. I plan to live until age 100 so I must save as well for medical expenses beyond age 80. I got for myself a variable universal life in equity fund and some mutual funds so that I will have a large sum of money when I reach age 80.

Now, I have peace of mind from health expenses. Hope you will find this post useful. Anyone is free to comment.  

P.S. If you want more info about our I-HEAL program, send me an email so I can send you brochure. :thankyou:
« Last Edit: Sep 18, 2011, 10:06 PM by mjtfernandez »
Top Financial Advisor of Insular Life. Request for a FREE life insurance, health, investment quote online at my blog site at mjtfernandez.com

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