HMO for Freelancers: Guide to Choosing the Right HMO Company

Your National Health Insurance is not enough to cover your hospital bills. If you want to be worry-free about medical insurance, what you need is HMO coverage. Today, we will show you everything you need to know about HMO – you will have the knowledge to protect yourself and your family even as a freelancer, not an employee.

What HMO: Why Is It Important for Freelancers?

HMO stands for Health Maintenance Organization. It is medical insurance that you pay monthly, quarterly, or annually. If you get sick, the HMO company will pay for your hospital bills, provided that your illness is covered by your insurance policy.

Think of HMO as car insurance. With car insurance, the company will pay for damages to your car if you get into an accident. HMO is the same, but for your health

Typically, only big companies pay for HMO of their employees. For freelancers, however, HMO coverage is not a common thing because of the cost. As a freelancer, however, you must understand that paying for HMO is critical.

If you get sick, you do not earn money. The difference between you and an employee is that an employee has sick leaves and other benefits. In addition, a typical company also shoulders the cost of HMO.

Big companies like call centers pay for the cost of health insurance for their employees. The employees have the option to add their children or spouses. Depending on the employee’s position in the company, he may pay for the insurance of his dependents. Usually, managerial and executive positions do not pay for their dependents—the company takes care of it.

Without HMO, you will suffer the burden of paying your hospital bills. So, consider that amount of money and the money you lost for not being able to work. Then, compare that to the amount of money you will pay to the HMO company, and you will realize that it is much more practical to pay HMO from your pocket.

How to Choose the Right HMO Company

The most important factors to consider when choosing an HMO provider are:

1. Coverage
2. Network
3. Price
4. Customer Service

Coverage refers to the number of diseases and illnesses that they will pay for in case they get sick. For example, some insurance companies may cover cancer or leukemia, but others don’t. You want to pick an HMO provider that covers many types of medical issues. In addition, some companies may cover doctor’s professional fees, and some don’t.

Network refers to the number of accredited hospitals and doctors. If a hospital is not accredited by the HMO company, you will not get reimbursed. You will pay your bills from your pocket. The bigger the network, the better.

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A Comparison of HMO Providers for Freelancers

In this section, we will compare the best HMO providers for freelancers based on our research.

✔️ Medicard Health Check

The monthly cost of this insurance is ₱500. If you want, you can add dependents, but then you will pay extra.

Here are the benefits:

• No limits on consultations
• Discounted payments for specialists like ophthalmologists and surgeons
• Discount of up to 20% on laboratory diagnostics and tests

In addition, the company provides outpatient care services. However, these are only available if you avail them from a MediCard free-standing clinic. The good news is that there is no age limit or pre-acceptance conditions.

✔️ Maxicare E-Ready

The next on our list costs ₱699 per month. They offer coverage for medical emergencies and conditions. What you will like about it is that they cover emergency medical expenses up to ₱15,000.

Here are some of the other benefits:

• Dental care is included in the HMO package
• You can get up to 15% discount in MyHealth Services
• There is a group life accidental death benefit, including dismemberment and disablement

The coverage for accident insurance is not a static value. It changes according to the situation, but beneficiaries can get up to ₱50,000.

✔️ PhilCare ERVantage

This HMO is a tad more expensive at ₱1,050 per month. They have plans for people above 40 years of age, and then there are different plans for those above 60 and 80.

Some of the key benefits are:

• Accident insurance of up to ₱40,000 for common rooms
• Semi-private room coverage up to ₱60,000

If you get a private room when you get hospitalized, the HMO company will pay up to ₱80,000.

✔️ Medicard RxER

Like the previous one, this is a bit expensive, as it costs ₱1,998 per month per insured person. However, the benefits are better.

Here are some key things about this HMO:

• Coverage of emergency trauma care up to ₱20,000
• Coverage of emergency diagnostic procedures up to ₱5,000
• Unlimited coverage for the services of primary care physicians

Finally, you can get up to 30% discount for procedures, provided that you go to the MediCard free-standing clinics.

✔️ Pacific Cross Select

This HMO is one of the most expensive, which costs ₱4,482 per person per month. Here are the benefits:

• Coverage of up to ₱500,000
• Coverage of multiple financial necessities such as emergency room expenses, hospitalization, critical care, and surgeries
• Annual physical check-ups or exam

This package also includes dental benefits and outpatient coverage or expenses.

✔️ Manulife

The last on our list is from a life insurance company. They offer multiple plans for freelancers, especially those who are fearful of critical illnesses.

Here are some options:

• HealthFlex Cancer – coverage for the treatment of cancer
• HeathFlex Cancer Plus – coverage for the treatment of cancer and 57 critical illnesses
• HealthFlex 3CI – coverage for the treatment of cancer and heart problems
• HealthFlex 3CI Plus – coverage for the treatment of cancer, heart problems, and 57 critical illnesses

The cost varies, and you must download their brochure if you need to know more. There is no price to each, as the company tailors each insurance plan according to what you need. 

Table of HMO provider comparisons:

COMPANY	COST	BENEFITS
Medicard Health Check	500	No limits on consultations Discounted payments for specialists like ophthalmologists and surgeons Discount of up to 20% on laboratory diagnostics and tests
Maxicare E-Ready	699	Dental care is included in the HMO package You can get up to 15% discount on MyHealth Services There is a group life accidental death benefit, including dismemberment and disablement
PhilCare ERVantage	1050	Accident insurance of up to ₱40,000 for common rooms Semi-private room coverage up to ₱60,000
Medicard RxER	1998	Coverage of emergency trauma care up to ₱20,000 Coverage of emergency diagnostic procedures up to ₱5,000 Unlimited coverage for the services of primary care physicians
Pacific Cross Select	4482	Coverage of up to ₱500,000 Coverage of multiple financial necessities such as emergency room expenses, hospitalization, critical care, and surgeries Annual physical check-ups or exam
Manulife	VARIES	Coverage for the treatment of cancer, heart problems, and 57 critical illnesses

So, what should you choose? While it may sound obvious that the cheapest is the best, it is not necessarily so. It may be cheap and affordable, but then the package does not cover a lot of situations. Read the policy and see what each has to offer to find out which one best suits your needs.

Pros and Cons of HMO for Freelancers

Here are the pros of HMOs:

• To some degree, you do not need to worry about hospital bills
• HMOs may cover diagnostic tests
• They cover professional fees
• HMO allows you to pay for your dependents

Here are the cons of HMOs:

• They do not cover medicines
• Not all HMOs cover the same types of illnesses
• Some of them will not cover pre-existing conditions

Tips for Getting the Best of Your HMO

Here are some quick tips to help you make the best decision.

1. Understand what illnesses you are preparing for
2. Get HMO for your dependents also
3. Pay on time
4. Read the policy so you understand which hospitals or doctors are accredited

In addition, find out if the HMO has a local clinic in your area. You will be surprised that though they cover check-ups and diagnostics, some of them give these services “free” only if you do them in their clinics. In addition, ask questions to the insurance representative before signing any document or before committing to a plan.

Summary

HMO is a medical coverage that everybody needs. No one is prepared to pay for hospital bills, so it is always better that you have a backup plan or coverage. Before you purchase HMO, make sure that they have a clinic near you.