all about HMO

[ms.rain]

^depende sa coverage. for my parents, 200,000 yung maximum coverage per year, im paying around 15,000 a year for each of them.

super naging useful sya saken. last year, na-max out ng dad ko yung card nya, he underwent some operations and procedures kasi. next week, meron nanaman ulet. buti nalang new year nanaman, may bagong 200,000 na coverage nanaman.

[rlin_0811]

if medicines for maintenance po ba, sakop pa ng healthcard?

[pink]

ms.rain, how old are your parents and saang HMO yan? most HMO kasi na napagtanungan ko di tumatanggap ng more than 60yrs old.

[DocShe_713]

rlin- no , maintenance medication are not part of the healthcard.

[ms.rain]

^^pink, intellicare yung samen. dati hanggang 60 years old lang, pero 2 years ago, naging up to 65 years old na. but i think hindi na nag-ooffer ng individual applications ang intellicare, company nalang ang meron.

my tita who is 63 i think has maxicare. im just not sure kung hanggang anong age pwede sa maxicare, baka up to 65 rin.

[rlin_0811]

docshe- thanks po for the information...

[hoku_daniel]

sana merong health insurance/HMO na pwede for senior citizens, [textspeak!] sila yung laging nagkakasakit and i dont know why the government does not do anything about this...
my parents are 62 and 72 and though di sila nagkakasakit, ayokong magworry about their health and gusto kong di rin sila magdadalawang isip magpacheck up kapag me nararamdaman sila.

[pink]

^same tayo. meron yata sa blue cross (not sure) but i still wanna look at other HMO companies.

[rumplehuey]

^ ako yung mom ko 61 na. hindi ko sya naiapply ng health card because of her age. Pero di ba unfair talga yun? Pero ang mas nakakainis dito, yun ibang health card, pwede mo i-apply ang parent who is already 60+ kapag naka group insurance. Like for example, sa company nyo meron kayong HMO, pwede ang dependent mo na upto 65 y/o. Depende pa yun sa plan ng insurance na kinuha ng company mo. Pero kung individual na health card, hindi sila pumapayag. Its true na mas kelangan talaga ng mga senior citizens ang health card, siguro kaya may limitations sila sa age kasi ayaw nilang magbayad sa hospital ng malaki. Pero diba, ang babayaran lang nman ng mga HMO na yan eh hanggan dun lang sa amount na  inapply mong insurance? Kung mag exceed na eh di i-shoulder na mismo ng patient. Grabe, mautak sila, yun mga taong may healthcard na halos hindi nagagamit eh pinag kakakitaan nila.

[ms.rain]

^ano yung healthcard na pumapayag sa above 60 pag corporate account and hindi pwede pag individual account lang?

all HMOs, business pa rin yan. risk sa kanila ang magcover ng above 60 dahil for sure lugi sila. imagine, u pay premium of 15k a year, pero yung sasagutin nila if ever is 200,000 kung mamax out ang coverage. sooner or later, magcloclose down HMO na yan since hindi nila masusustain ang operations nila.

problem really lies with our government and how healthcare is being addressed in our country. 

masnakakainis yung nabasa ko sa insurance thread dito sa GT. she was denied of getting eve's devotion insurance with philam kasi overweight sya. ano ba naman yan! marami naman overweight na tao na perfectly healthy. the GTer is only in her 30s, tapos nadeny na sya ng insurance. hay naku naman talaga o! i would understand kung may medical condition na malala, yun, pwede pa nila ireject ang application. but to reject one's application because of weight issues?! tsk tsk.

[ms.rain]

^^^pink, blue cross covers up to 65 yrs old. BUT if you are above 65, no problem pa rin! they have blue cross premiere... kahit 90 yrs. old pwede! iba iba lang premium for each age bracket. 66-70 yrs old, 71-75, 76-80, 81-85, then 86 and above. premiums are also categorized into ward, semi-private and private.

eto list ng premiums: http://www.bluecross.com.ph/assets/file/premier_premiums.pdf
core benefits: http://www.bluecross.com.ph/assets/file/premier_benefits.pdf

maganda rin yung blue cross premiere coz covered ka kahit sino ang doctor at saan ang hospital. it's not like what some of us have now na kelangan affiliated doctors and affiliated hospitals. maximum coverage one can get is up to 1.5M.

the premiums are way higher than the usual but kung kaya naman, i think okay na bigyan natin mga senior citizens nating parents/grandparents this kind of coverage.

[ms.rain]

double post deleted

[pink]

^thanks sis. wala na bang iba na pupwede ang 60 yrs old and up? i wanna have choices kasi.

[prettynvain]

^ sis try mo medicard. naapprove application ko for my dad. he's 60 and will be 61 this july. individual application. my dad also has intellicare na apply ng brother ko, kasi company nila provides intellicare. pero namax-out na yung intellicare and october pa uli pwede marenew. diabetic kasi dad ko and may kideny failure, he's undergoing dialysis, and covered naman yun ng both healthcard.

[rumplehuey]

Medicard does not accept enrollees who are over 60 years old kapag Individual insurance. Baka naman dependent mo ang dad mo sa medicard kaya na approve. I tried to apply for my mom who is already 61 pero ayaw nila pumayag. Hindi ko lang sya naisama sa pag enrol ko dito sa company namin as dependent for 2008 kay ni try ko mag individual insurance for my mom kahit bayaran ko na ng buo ang premium pero ayaw pa din nila pumayag.... 

[dalmatian]

Any feedback sa ICare HMO?

[lencute]

i was looking for this thread:

anyway, i tried calling fortunecare and it looks okay. pre-existing is waived on the first yr but on the second yr, you can use the maximum limit of your card. me quarterly payment din sila thru bdo.

i called the agent na. dalawa na lang choices ko. either i get the bluecross insurance or this.

[lencute]

Any feedback sa ICare HMO?

hay naku naconfuse na naman ako when i saw the website of icare..mukhang ok din

[pink]

i finally received the info i need from fortunecare regarding their individual program. affordable naman. but from what i understand sa binigay nilang rates table sa akin, di yata iba-iba ang rates per age bracket... or maybe yun lang ang binigay kasi when i asked may specific age bracket akong ibinigay.

gotta send another query to them.

[lencute]

i have the same rates sis. ganun daw talaga ang sa kanila. walang age bracket.

try mo tong icare

http://www.icare.net.ph/rates.html