Employees consider HMO the most important benefit an employer can offer; it has become one of the top perks an employee believes in when choosing which company to join. That said, it’s crucial for the employer or business owner to select the right HMO that serves the company’s needs.
Not all healthcare providers have the same benefits; one provider may be the best for one client but may not necessarily be the best for the other.
It’s a tedious process to compare different HMOs. Still, with the proper knowledge and help from experts, choosing a plan that suits your employees’ needs while considering your company’s financial means is possible.
Here are the top 5 considerations when choosing the best HMO provider:
Top #1 Determine the Needs of Your Employees
Determine the needs of your employees regarding a health care plan. There are different types of HMO services in the Philippines.
Some HMOs are pre-paid but have limited coverage which is perfect for those wanting a basic health care plan, there are packages for out-patient consultations only, and there are those that assist both in-patient and out-patient consultations. There are plans specifically made for corporate and small/medium enterprises (SMEs).
Pro tip: The more comprehensive the plan is, the higher the cost is. Take into consideration the needs of your employees, which will determine how comprehensive your health care plan should be.
Top #2 Check the network of providers
The primary reason for getting an HMO is to provide a sense of security to your employees that any time there’s a medical emergency or sickness, they don’t need to stress over how to fund their medical expenses. Hence, it is highly important to choose an HMO provider that has a wide network of hospitals, clinics, and doctors nationwide.
Pro tip: Make sure it is accredited by hospitals near your workplace too to provide convenience in case they need to seek medical attention.
Top #3 Confirm if the plan covers pre-existing conditions (PECs)
All illnesses/ medical conditions present before availing of the HMO WILL NOT be covered unless specifically included in the contract, so be sure to confirm that PECs are included in the package.
The following may be regarded as pre-existing conditions:
- Hypertension or high blood pressure
- Tumor
- Cancer
- Diabetes
- Goiter
- Cataract
- Cyst
- Arthritis
These are just a few, so make sure to get a complete list of PECs that the HMO company considers and ask if it’s included in what you are getting.
Pro tip: You must be thorough with your research and ask for all necessary information from your broker/ agent. Your employees will highly benefit if the plan covers PECs.
Top #4 Cost–Benefit Analysis
How do you know if the HMO offered to you is a good value for money? List down all the benefits you can get and even the cons of the HMO being offered to you, and then compare that to the amount you are paying. It would be best if you also considered the Maximum Benefit Limit (MBL) or the consumable limit one can use per year because once you go over your MBL, the extra cost will be shouldered by you or your employees.
Pro tip: Compare offers from at least three different HMO providers and see which one is the most competitive.
Top #5 Ask all the plan inclusions
Ask if the health plan includes an annual physical exam and what other medical tests are included. Other plans also include dental coverage as well as vision care.
Here’s a quick checklist of what you need to ask your agent or broker:
- Hospital confinement
- Non-emergency confinement or surgery (elective cases)
- Out-Patient Care
- Preventive Health Care
- Dental Care
- Pre-existing conditions (PECs)
- Network of providers
Selecting the right HMO for your company takes time, research, and effort. More often than not, it’s best to work with trusted and experienced professionals who can explain all the pros and cons of different HMO providers to save time and money.
At Pascual Brokers, we simplify your choices. Whether you are looking for the best HMO for you, your family, or your company, we are here to help!
Canvass now with us. Reach us at (02) 8995 – 3577