health insurance

Best Health Insurance Plans for Senior Citizens in the Philippines

Health is wealth. At least good health brings the wealth, but poor health drains it with medical bills that your family may have to pay with hard-earned savings or even loans when badly needed. This becomes more problematic in senior years. Budgeting a strict fund is harder with deteriorating health. As you grow old and start to live on a pension not having to worry about medical expenses is a huge relief.

Health maintenance organizations (HMOs) and insurance companies offer to shoulder expenses to maintain good health or treat arising illnesses upon availing their policy. You pay a small amount for huge returns as deductions or reimbursements from your bill. There are many health insurance plans to choose from. Whether you’re looking for the perfect retirement gift for your parents or for yourself, we have rounded up the factors to consider before availing senior’s health insurance, as well as the best policies in the country.

 

health insurance

What are your options?

There are two types of health insurance plans – comprehensive plans and prepaid health cards.

Comprehensive health insurance

Comprehensive plans offer a wide range of benefits like in and out-patient care, emergency care, maintenance, and financial assistance to your family in case of your death. You’ll have to pay monthly or annual premiums to get reimbursement on your medical bills. However, not 100% of your bills are returned to you by your HMO. Having them pay a fraction of the bill is helpful when you expect huge medical expenses in the future. But a plan that reimburses an exact amount is better for cheaper procedures where the bill is fully payable by the HMO.

Besides the premiums, there are also deductibles, copayments and coinsurance fees to consider. These are a part of your medical bill that you shoulder with your insurance provider when you use your policy. Clients who need regular hospital appointments might opt for lower copayments for a higher premium. Similarly, people who only want insurance for emergencies would want low premiums and a higher copayment.

Comprehensive plans are more common, thus you would have multiple choices depending on your budget and desired benefits. There are many health insurance providers in the country where you can have a customizable plan. Others have readily available policies you can directly pick from as well. Listed below are notable features from some health insurance plans.

Pacific Cross Premier

  • Emergency overseas coverage. If you travel frequently, you can rest assured that you’re insured for any emergency leading to confinement. Only a few companies have insurance coverage outside of the country!
  • Your choice of hospitals and doctors. Pacific Cross doesn’t restrict your pool of options when it comes to health care. Yes, you don’t have to travel to a specific HMO-accredited hospital to be reimbursed of your expenses.
  • Increasing annual premiums. Since health risks rise with age, Pacific Cross accordingly increases your annual premiums for every additional year of coverage.
  • 10% Copayment. The company reimburses up to 90% of the approved claim amount

Sunlife’s Sun Senior Care

  • Fixed premiums. Unlike the previous company, Sunlife offers the plan for a fixed premium when you avail for 3, 5, or 10 years. Their price is independent of your age.
  • Earn dividends. If you’re unable to use your benefits for some amount of time, Sunlife rewards your good health by dividends from your plan. You can use this to pay for your next premium or you can even receive it in cash!

Paramount Direct’s Prime Care Cash Plan

  • Annual premiums are as low as ₱2,550! This includes daily ICU benefits and surgical cash benefit. This is possibly the cheapest comprehensive plan out there, though also with minimal benefits.
  • Coverage until 80 years old only. Most insurance companies allow coverage up to 100 years old.

Prepaid health cards

Prepaid health cards are a lot cheaper for more specific benefits before its expiration date. This is for when you don’t need everything offered in the comprehensive plan, or when you just want security for a small amount of time. For example, you can opt to avail only an emergency card, and not a maintenance one if you’re relatively healthy. Health card prices also remain the same regardless of age beyond 60 or 65 should you choose to repurchase one every year. Most health cards cover most pre-existing conditions. Usual exclusions are maternity, and psychological or behavioral disorders whether acquired or congenital. Comprehensive plans usually take time to approve coverage for diseases diagnosed before your purchase.

Health cards also offer less hassle and policy commitments after your purchase. With prepaid cards or sachet insurance, you wouldn’t have to bother with filing reimbursement forms and waiting for approval from the HMO. You just have to swipe, beep, or show your card and the corresponding discount is taken off your bill immediately. Unlike comprehensive plans, there is a guarantee in availing health cards as they do away with prior health check-ups. We have listed the following prepaid health cards and their benefits in increasing price.

MediCard RxER


₱1,998.00

  • No age limit! You can avail this even before senior citizenship. They require no prior medical check-up, as well.
  • Emergency health care
    • Up to 20,000 for emergency trauma care. This includes ER fees, professional fees, and emergency medication for trauma cases within 6 hours from the time of incident, burns, animal bites, and accidental chemical poisoning
    • Up to 5,000 for emergency laboratory and diagnostic procedures.
    • Guaranteed 100% reimbursement for emergency health care in non-MediCard-accredited hospitals.
  • Preventive, out-patient, and dental health care at MediCard free-standing clinics
    • Free unlimited consultations with primary care physicians, pediatricians, medical internists, gynecologists (non-maternal concerns)
    • one annual physical exam (complete blood count, general check-up, chest x-ray, urinalysis, fecalysis)
    • free dental consultations and one oral prophylaxis
    • 30% discount on other dental procedures, laboratory and diagnostic tests, surgeries, and procedures at Skin & Body Laser & Aesthetic Center by MediCard.

Philcare Unli-Consult for 65-plus


₱5,000.00

  • Unlimited medical consultations with Philcare-accredited physicians nationwide.
  • Most pre-existing conditions are covered. Exceptions are aforementioned cases.

Philcare Vida Care CORE


₱11,120.00

  • Unlimited medical and dental consultations to all accredited physicians nationwide
  • Unlimited OP laboratory and diagnostics procedures available at Philcare-owned clinics except Physical Therapy
  • Most pre-existing conditions are covered.

Maxicare Prima Gold

 
₱12,999.00

  • UNLIMITED out-patient consultations, and prescribed laboratory and diagnostic procedures with select doctors and hospitals.
  • Coverage for all pre-existing conditions.
  • FREE select dental care services from Metro Dental
  • Up to 100,000 ER coverage in Maxicare-affiliated hospitals

 

Philcare Vida Care PREMIER


₱13,270.00

  • All Vida Care CORE benefits
  • Up to 20,000 of emergency care benefits. This includes
  • Doctor's fees
  • Laboratory and diagnostics procedures
  • Special modalities of treatment as medically necessary during ER and subject to P5,000 inner limit
  • Medicines (except vaccines) as medically necessary during ER,  subject to standard inner limits
  • Diagnostics and therapeutic procedures as medically necessary during ER

 

Bottom Line:

Many factors come to play when investing in your health. Different plans are built for different people. Comprehensive plans might be more expensive but are more cautious as they offer extensive benefits. Prepaid health cards are for those who want good health insured for a lower price, as most health cards offer unlimited consultations.

Pick the insurance policy that accommodates you perfectly, and you won’t have to break the bank for good health. You can spend your much-deserved retirement funds for other needs and even luxuries!