all about HMO

[ms.rain]

^parang extreme nga yan. that's so sad. nasa contract ba nila yan? if not, contest mo. or kung kaya, paki-usapan mo. dapat may grace period man lang.

hindi ba talaga nagpapadala ng billing ang caritas? weird naman nyan. paano malalaman ng tao na it's time to pay their premiums na? 

[purrple]

It's really sad.

Since 2004, we have never received any statements from them reminding us of our dues.  My mistake is that, I lost the policy.  I already asked for another copy, but it will take 2 weeks (I'm sure, longer) before I get it. 

Yes, dapat meron manlang grace period.  In my case, TWO DAYS lang!  Isang beses lang because I was really busy and it slipped my mind. 

I already wrote an appeal letter last year, after more than 2 months of waiting, they shortened the pre-existing period from 12 to 9 months.  But even so, the membership is branded as new, therefore even if I'm a member since 2004, I still have limited benefits.  Sobrang unfair talaga.

So if you know any organization or place where I can file a formal complaint, please let me know.  I'm sure hindi lang ako ang nakalimot magbayad one time in their membership life.

[ilyababy]

^ Trust me. Don't bother writing to them, super useless sila kausap. I also have Caritas Healthshield and during that time, I needed to have an operation, the operation has to be done in the operating room of the hospital since they have the necessary equipment needed. Take note, it was already my 4th yr, aba, you know what they told me? Covered lang daw yun sa kanila if the operation will take place in the clinic of my doctor. O di ba? kahit na nakipag-away ako dun, binastos pa ko nung girl sa reception (but that's another story), I wanted to slap her right then and there.

Sabi nga ng doctor ko, they know that the procedure needed to be done in the hospital, pero excuse nila yun to not pay for the procedure. Actually, I'm just waiting for the 10 year period so I can cash in the healthcard, I have no plan of continuing such a useless HMO.

[purrple]

@ilyababy, thank you for your comment.  At least hindi ako nag-iisa.  I really feel bad.  Sa sobrang mahal ng premium nila, I never thought ganun sila kadaya.  Ako din, as soon as I finish paying for it sa December 2009, I'll get my money.  Ayoko na magantay ng 10 years.  I don't want to deal with them anymore.

True, they can be disrespectful lalo na sa mga matatanda na medyo makulit.  Pag ayaw nila approve yung mga laboratory kasi mahal, kung [textspeak!]-ano hinihingi nila requirements and halos ipagtulakan nila paalis.  Nakikita ko pag kumukuha ako ng LOA sa mga clinic nila. 

Wala ba talagang place kung saan pwede magreklamo sa ganito?  I'm thinking of ireport sa abs cbn.  I'm sure hindi lang tayo ang nakaexperience ng ganito sa kanila.  Nakakainis!

[ilyababy]

^I also wrote a complaint letter to the president of Cartias, I didn't even get a reply! So, like I said, USELESS and WORTHLESS HMO ang Caritas.

Kelan ba pwede i-cash in yun card nila, di ko kasi sure if 10 years ba or what e?

If ever may nahanap kang institution kung san natin pwede i-complain yun Caritas na yan, let me know. Thanks.

[purrple]

@ilyababy, from what they told me (they can be unreliable as in iba-iba ang sinsabi and I cannot quote them kasi over the phone lang), pag nag-end yung plan, which is after 5 years, you have the option to either get more than half of what you paid for or extend your plan for another 5 years na free na and then after that, get 70% ata of your investment.  Ako, wala plano patagalin talaga.  Since December 2004 ang membership, so this December 2009, cash-out na ako agad.  Super galit talaga ako sa kanila.

I'm going to write a very long letter sa ireport@abs-cbn.com, kasi nakita ko sa tv that if you have any complaints, pwede sa kanila.  Ang gusto ko lang, malaman ng maraming tao kung gaano ka-unfair ang services nila, to think hindi naman sila cheap.  I will definitely tell you if anything comes up, kasi sobrang galit talaga ako. 

I'm going to request for the policy kasi nawala ko nga, I cannot check if lahat ng sinasabi nila sakin is indeed written in the policy, as in clealy and not assumed or interpreted lang to their advantage.

[iluvescadasport]

any feedback on maxicare & fortune care? I'm choosing between the two

[poshprincess]

i'd choose maxicare.. although i havent tried fortune care..

in the past i have already tried intellicare, medicard and maxicare..

the best tlaga ang maxicare..

even sa hospitals/ clinics.. i was able to prove that they prioritize on maxicare HMO.. accdg to one of the nurses.. mas mablis kasi mag remit ang maxicare compared sa other HMOs kaya alam nyo na.. mas favorable sa kanila yun..

im not sure about fees and payments though.. never experienced paying for any of  it  kasi company benefit siya..

[angelspawn]

does anyone know if MAXICARE covers pre-existing conditions like endometriosis?

depende yata sa plan yun sis... sa min kasi covered yun eh sa mismong employee ah. pero pag sa dependents, after 2 years in the company pa sya macocover.

[bruce_lyn]

pasali mga sis later mag back read ako. since  I am planning to get my own healthcard. mabasa mga experiences nyo

[miss_o]

nakakainis ang medicard.. yun kasi ang health card ng company ng hubby ko.. last december naibigay na sa kanila yung medicard nila pero para sa mga dependants hangang ngyon hindi pa rin nila naibibigay.. sabi nila january daw ibibigay eh hanggang ngayon wala pa rin.. kinakaltasan na nga sila pero yung card namin di pa rin naibibigay.. ang ginagamit ko tuloy is yung medicard ng asawa ko...

[bump]

^that's what i heard too sis, too bad talaga! ... i read though sa endometriosis thread that one of our sisses there said that their company HMO - Medicard i think - will cover her endo-laparoscopy ... how come kaya sa kanya covered ng HMO nya? 

our HMO covered my cryosurgery dati

[chinita8]

our HMO covered my cryosurgery dati

what's your HMO sis?

[iluvescadasport]

question lang re: HMO. For example, magmember ako sa company X. Tapos, what if let's say, after 2 years, ayaw ko na ituloy, so papa-cut ko na. Mababalik ba yun pera na hinulog ko sa kanila? Or hindi?

[honey_iya]

^hindi na sis.

[quian]

medicard ako. i want to use it naman, but im totally clueless where i can avail of the services. im from QC though. any help? or if you know any dentist na medicard accredited in QC. pati ba dematologist?

[nelle21]

may website ang medicard ha, hindi ko lang ma-trace! almost all hospitals are medicard accredited.

[angelicious]

Mga sis question lang, kapag iaavail ba ang dental cleaning sa medicard eh talaga bang bara bara ang gawa ng dentist.. Kase kanina nagpa cleaning ako sa MD Eastwood wala pang 10 mins tapos na cleaning ko!!! di man lang nilisin, walang brush.. kinutkot lang ang ngipin ko... Mas matagal pa yung hinintay kong oras sa kanya kesa sa pag cleaning ng teeth ko!!  Nagsayang lang ako ng oras.. Binentahan pa ako ng mouthwash worth 300 at dun sa kasama ko 350 eh same lang naman!!!.... Mabuti pang nagbayad nalang ako sa dentist for dental cleaning!!!

Di ko na gagamitin Medicard ko for free cleaning! Magbabayad nalang ako!

[rumplehuey]

I have availed of the dental cleaning pero hindi ako naka experience ng bara barang trabaho. 3x ko na nagamit. Siguro depende sa makukuha mong dentis yan.

[rumplehuey]

Sino dito gumagamit ng Fortunacare?

Gusto ko lang sana malaman kung nagamit nyo ba for lab tests sa first year ng membership nyo yun card?

Kinuha ko kasi ang dad ko ng fortunecare and paid the whole annual fee because I thought na mgagamit nya yung card for lab tests. But then, when my father went to fortunacare in FEU, they said na hindi daw magagamit ang card for lab test kasi unang taon pa lang daw.Sa 2nd year pa daw magagamit ang card for PEC.