Most people think that health insurances are the same. But in reality they are not. In this article we will explore the different types of health insurances in the market today.
The statistics on health risks are shocking
1 in 2 will develop cancer (43.9%)
1 in 6 will have stroke before age 55 (16.7%) and
1 in 2 will develop coronary heart disease (50%),
These statistics just shows how important it is to take care of our health especially that health related expenses are now on the rise. But, with the environment that we are living in and the food we take, it cannot be helped that some time in our life, we might be inflicted with diseases but hopefully not the critical ones.
Being sick can be a burden especially to the people who are taking care of you either physically and financially that is why it is important that we all have health insurances.
Dr. Marius Barnard, one of the members of the team who made the world’s first successful human heart transplant in 1967 once said “as a medical doctor, I can repair a man physically, but only insurers can repair patient's finances. Medically, you may survive. But financially, you may die due to the costs associated with it.”
In the Philippines we have what we call health cards (HMO) and health insurance. These two are not the same. Let us look at the main differences between the two. For simplicity purposes since I am a financial advisor of Insular Life, I will be explaining from the perspective of Insular’s products: health card with Insular Health Care (I-Care) and health insurance which we call (I-HEAL)
Here are the major differences between the two:
HMO (health card)
I-CARE
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Health Insurance
I-HEAL
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1. Payable every year until age 65
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1. Payable in 5, 10 or 20 years
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2. No payment for the year means no coverage for the year
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2. Client need not pay after completion of the paying period, coverage until age 80.
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3. Premium increases every year
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3. The premium at the time of application becomes the lock in premium until the payment period is completed
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4. Applicable to accredited doctors and hospitals (since it’s no cash outlay type since you just give your card to be admitted)
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4. Open access to any doctors and hospitals (since it’s a reimbursement type of medicines, doctor’s fees and surgery expenses)
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5. No death benefit to beneficiaries in case insured dies of natural death
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5. Death benefit given to beneficiaries when insured dies of natural death
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6. All premiums paid will not be refunded when the coverage expires at age 65.
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6. All premiums paid plus 25% will be refunded when the coverage expires at age 80.
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7. Dreaded diseases are usually covered up to a certain limit (usually P150k Max)
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7. Dreaded Disease Rider provides additional lump sum benefit of up to P1.5M for dreaded diseases such as cancer on top of the reimbursement benefits.
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8. Covers out- patient expenses but out-patient expenses are usually minimal expenses only
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8. Covers in-patient only but addresses highly expensive medical fees like surgery, doctor’s fee and medicines
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9. Card Type - Hospital and Insurance company coordinates with each other for payment of claims
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9. Reimbursement type – Insured and Insurance company coordinates with each other for reimbursement of claims
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10. **HMO is strongly recommended for individual with high utilization, with adverse personal and family health conditions usually brought by old age
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10. **Long term health care is strongly recommended for individual whose age ranges from 0-45 years old, at present with good health condition but planning to prepare for future expensive medical fees and with very minimal utilization
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