Medical insurance and HMO plans are more than just safety netsātheyāre tools for proactive health management. Yet many policyholders underutilize their coverage, missing out on valuable services and savings. We believe that informed clients are empowered clients. Hereās how you can make your plan work harder for your health and your wallet.
1. š©ŗ Use Preventive Care Services
Most HMO and medical insurance plans include free annual check-ups and/or screenings. These services help detect issues early and reduce long-term costs.
Tip: Schedule your annual physical and dental cleaningāeven if you feel fine. Prevention is cheaper than cure.
2. š Understand Your Coverage Details
Take time to review:
- Inclusions and exclusions
- Hospital and clinic partners
- Specialist access
- Emergency protocols
Knowing whatās covered helps you avoid surprise bills and make informed decisions during emergencies.
3. š§ Know the Mythsāand the Facts
Many Filipinos believe HMO cards are only for hospitalization or that unused benefits roll over. Not true. Benefits often reset annually and include outpatient services, mental health consults, and more.
Tip: Ask your provider for a full benefit rundown. You might be missing perks like teleconsults or wellness programs.
4. š„ Choose Accredited Providers
Using partner hospitals and clinics ensures smoother processing and lower out-of-pocket costs. Non-accredited providers may require reimbursement and longer wait times.
Tip: Keep a list of nearby accredited facilities for quick access during emergencies.
5. š Call Before You Go
For specialist consults or procedures, some plans require pre-authorization. Calling your provider beforehand avoids denied claims and ensures proper documentation.
Tip: Save your HMO hotline and member ID on your phone for easy reference.
6. š¬ Ask Your Agent for Help
A licensed agentālike meācan:
- Explain confusing terms
- Help file claims
- Recommend upgrades or add-ons
- Advocate for you during disputes
Donāt hesitate to reach out. Your agent is your ally.
7. š Review and Adjust Annually
Your health needs change. Review your plan every year or after major life events (e.g., childbirth, surgery, job change). Consider upgrading if your current plan no longer fits.
š± Final Thought
Your medical insurance and HMO plan are powerful toolsābut only if you use them wisely. Fati is here to help you understand, access, and maximize every benefit available. Because your health deserves more than coverageāit deserves care.
