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Kreole

Medical Insurance in the RP

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Kreole

I am planning to live in the RP for 12 months. Medicare will begin for me in November. However, I am considering dropping Part B, since I will not be in the US to use it anyway. Currently, I am a member of Group Health and am also considering dropping that coverage as well. Do members here find the coverage in the RP equal to that in the US? I have read in this forum, that the quality of healthcare in the RP is substandard in comparison to US. However, the costs for a top notch policy is a great deal cheaper in the RP, but that does not necessarily equate to equal care. Has anyone been in this situation before, and if so, what was your experience? I do plan to get a medical insurance policy while I am in the RP. Does anyone know the cost of the best policy available, and which company? Thanks

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CardiacKid

I am planning to live in the RP for 12 months. Medicare will begin for me in November. However, I am considering dropping Part B, since I will not be in the US to use it anyway. Currently, I am a member of Group Health and am also considering dropping that coverage as well. Do members here find the coverage in the RP equal to that in the US? I have read in this forum, that the quality of healthcare in the RP is substandard in comparison to US. However, the costs for a top notch policy is a great deal cheaper in the RP, but that does not necessarily equate to equal care. Has anyone been in this situation before, and if so, what was your experience? I do plan to get a medical insurance policy while I am in the RP. Does anyone know the cost of the best policy available, and which company? Thanks

First, if you drop Part B and re-enroll later, you will pay a higher rate. Medical policies here contain provisions that exclude pre-existing conditions for 1-2 yrs or in some cases, for the life of the policy. Costs of the policy depend on what level of coverage you want. Most do not cover drugs except in the hospital, so if you have maintenance meds you get nothing and if you are prescribed drugs for a condition that does not require hospitalization, you are not covered. This also includes drugs prescribed upon discharge from the hospital. Most policies here will not cover you past 70 yrs of age. Google Blue Cross Philippines and see if you can get a quote. Hospital charges here are based upon what type of room you have. If you have a semi-suite or suite room you will pay more than if you are in a private room. This includes everything, lab charges, X-rays, and doctor professional fees. Hospital care in Cebu or Manila is on a par with the U.S. if you go to a major hospital. Many doctors are U.S. licensed in addition to here. If you had about $25,000 you could self insure and keep the money in a instantly available account. You will receive no care here without a deposit up front and are expected to pay your bill in full before discharge.

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TorJay
You will receive no care here without a deposit up front and are expected to pay your bill in full before discharge.

 

This is not entirely true. In January, I ended up at Manila Doctors Hospital in Manila overnight for a suspected heart attack. It turned out not to be a heart attack TG. No money was requested up front. I was presented with a bill for around 4500 pesos upon my discharge which I promptly paid in cash.

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Kreole

First, if you drop Part B and re-enroll later, you will pay a higher rate. Medical policies here contain provisions that exclude pre-existing conditions for 1-2 yrs or in some cases, for the life of the policy. Costs of the policy depend on what level of coverage you want. Most do not cover drugs except in the hospital, so if you have maintenance meds you get nothing and if you are prescribed drugs for a condition that does not require hospitalization, you are not covered. This also includes drugs prescribed upon discharge from the hospital. Most policies here will not cover you past 70 yrs of age. Google Blue Cross Philippines and see if you can get a quote. Hospital charges here are based upon what type of room you have. If you have a semi-suite or suite room you will pay more than if you are in a private room. This includes everything, lab charges, X-rays, and doctor professional fees. Hospital care in Cebu or Manila is on a par with the U.S. if you go to a major hospital. Many doctors are U.S. licensed in addition to here. If you had about $25,000 you could self insure and keep the money in a instantly available account. You will receive no care here without a deposit up front and are expected to pay your bill in full before discharge.

 

It is disappointing to hear that the waiting period for pre-existing conditions is up to 2 years and may not be available in some RP policies. That said, it is highly unlikely that any of my pre-existing conditions would require hospitalization. For myself, I am more concerned with major medical policy, for accidents or unforeseen health issues. However, I am curious about your statement that a patient in a suite or semi-suite would have to pay a higher price. That seems to be a blatantly opportunistic policy, if it is indeed a written policy. Or does this come under discretionary (discriminatory) application? If you have resources or are a foreigner (rich of course) do they just hit you up with higher charges for the same service? If you have an RP medical policy, wouldn't the RP insurance companies be up in arms against it, since they would have to pay part of the bill?

 

In addition, I am considering including a friend in my policy. Is that possible? She has a young infant that was recently hospitalized for a bacterial infection that required intravenous fluid and food. They were in the hospital for 3 days in a private suite that costs 2500 p per day. All costs, including medication, emergency room, doctor fees and lab tests, came to about $450. Rather that pay another $450 out of pocket , I would hope to pay for a medical policy that would cover them. However, I am not the child's biological father, nor am I involved with the mother. Since we are not married or related, is it possible to get such a policy to cover me, and them as well?

 

Also, I would like to explore the $25,000 self-insurance policy. I have never heard of that before. I will do a search, but if you have information or links, I would much appreciate it.

Edited by Kreole

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TorJay
In addition, I am considering including a friend in my policy. Is that possible?

 

Any insurance policies that I know of are either individual or family. As she is not related to you she would not be eligible to be added as a family member.

 

Another option is that you can definitely fund her family policy. But, you cannot be included.

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CardiacKid
Also, I would like to explore the $25,000 self-insurance policy. I have never heard of that before. I will do a search, but if you have information or links, I would much appreciate it.
In addition, I am considering including a friend in my policy. Is that possible? She has a young infant that was recently hospitalized for a bacterial infection that required intravenous fluid and food. They were in the hospital for 3 days in a private suite that costs 2500 p per day. All costs, including medication, emergency room, doctor fees and lab tests, came to about $450. Rather that pay another $450 out of pocket , I would hope to pay for a medical policy that would cover them. However, I am not the child's biological father, nor am I involved with the mother. Since we are not married or related, is it possible to get such a policy to cover me, and them as well?
The self insurance option means simply that you would pay all your medical bills out of a medical savings account with no expectation of reimbursement. Costs are low here, and your $25,000 would cover anything except cancer. It would normally be enough to cover even a heart attack. You could do this by having a high limit credit card and using it. Pay it at your leisure. For your friend, I would recommend you pay for her to enroll in Phil Health. http://www.philhealth.gov.ph/ :link: It is quite inexpensive and covers most illnesses. Downside is there is a 9 month wait after she joins before they pay anything. To me, it's premiums are a real bargain for the coverage provided.

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Kreole
The self insurance option means simply that you would pay all your medical bills out of a medical savings account with no expectation of reimbursement.

 

Basically, what you are saying is that this is not really a policy with an insurance company, but just a savings account with $25,000 in it. So, self-insurance actually means no insurance at all. Did I misinterpret?

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enoonmai
I do plan to get a medical insurance policy while I am in the RP. Does anyone know the cost of the best policy available, and which company?

I have Blue Cross Philippines (not related to Blue Cross, U.S.), the rates will depend upon your age and the options you choose, for me it was about $1300 a year for emergency care only, no outpatient. I purchased the policy last August, in Sept I was in a bad motorbike accident and was in the hospital 22 days, including a major operation. I was in a private suite when I wasn't in ICU, I think the total costs were over p1 million. BC paid all except for some miscellaneous fees. The member "Stagger" (Andy) is an agent, you can PM him for details if interested.

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enoonmai
Most do not cover drugs except in the hospital, so if you have maintenance meds you get nothing and if you are prescribed drugs for a condition that does not require hospitalization, you are not covered. This also includes drugs prescribed upon discharge from the hospital.

Maybe most do not, I don't know. But in my case, Blue Cross paid for all medications (and outpatient visits) related to my hospital stay for 90 days after discharge.

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Kreole

I have Blue Cross Philippines (not related to Blue Cross, U.S.), the rates will depend upon your age and the options you choose, for me it was about $1300 a year for emergency care only, no outpatient. I purchased the policy last August, in Sept I was in a bad motorbike accident and was in the hospital 22 days, including a major operation. I was in a private suite when I wasn't in ICU, I think the total costs were over p1 million. BC paid all except for some miscellaneous fees. The member "Stagger" (Andy) is an agent, you can PM him for details if interested.

 

Thanks for the information. I am on the Blue Cross site now. For $1300, it sounds like you got more than your money's worth. Was there any deductible? Also, I am a bit confused when you say your policy covered only emergency care. So, it appears that emergency has a broader definition to include extended hospital and medical care after your initial admittance. This is the type of policy that may be more suitable for me.

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CardiacKid

Basically, what you are saying is that this is not really a policy with an insurance company, but just a savings account with $25,000 in it. So, self-insurance actually means no insurance at all. Did I misinterpret?

No insurance at all is correct.

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enoonmai

Thanks for the information. I am on the Blue Cross site now. For $1300, it sounds like you got more than your money's worth. Was there any deductible? Also, I am a bit confused when you say your policy covered only emergency care. So, it appears that emergency has a broader definition to include extended hospital and medical care after your initial admittance. This is the type of policy that may be more suitable for me.

I have Blue Cross Royale Plan A, I believe it was $1385 annual. I elected no deductible but that is an option. Emergency is not the right word, I elected In-Patient or Core Benefits, no Out-Patient. It covered the ER, entire hospital stay, and 90 day Out-Patient visits and medications. I elected the limited coverage area at 25% discount which excludes North America, Hong Kong, and some other places but you are still covered if you need emergency medical care in those countries. There was quite a bit of out of pocket paid by me during the hospital stay but it was all reimbursed by check to me by 15 working days after submission of claim. I didn't even submit the claim, I just handed the receipts to the rep.

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CebuKano

 

I have Blue Cross Royale Plan A, I believe it was $1385 annual. I elected no deductible but that is an option. Emergency is not the right word, I elected In-Patient or Core Benefits, no Out-Patient. It covered the ER, entire hospital stay, and 90 day Out-Patient visits and medications. I elected the limited coverage area at 25% discount which excludes North America, Hong Kong, and some other places but you are still covered if you need emergency medical care in those countries. There was quite a bit of out of pocket paid by me during the hospital stay but it was all reimbursed by check to me by 15 working days after submission of claim. I didn't even submit the claim, I just handed the receipts to the rep.

 

This is very useful first-hand information. Especially your first-hand knowlege of what was covered during your hospital stay. Thanks.

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Kreole

I really appreciate you all sharing this information, especially your personal experiences. Things always look better on paper, but fail to deliver when insurance companies pull out the magnifying glass to show the fine print exclusions. It has risen to an art form of deception and exclusions which may leave a person without coverage they thought they had. This is the true value of personal experience, since it is a real world application. I am looking in Blue Cross, and specifically the plan enoonmal is on, which seems like the type of plan most applicable to my situation. Blue Cross states that the "contracts" are good until the age of 100, although adjustments in coverage may (will) apply.

 

Attached is the online brochure that was recently sent to me. It is very helpful in delineating the details of the various plans.

Blue Royale E-Broch_2011-02 (Feb)_low res (2).pdf

Edited by Kreole

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stagger

The brochure you uploaded is from last year.

 

The difference in this year is, of course a change in the premium rates.

 

I received all the new Brochures from Blue Cross last week, unfortunately I cannot seem to upload files to the site at the moment.

 

I will contact Paul to see if he can fix the problem and then I will upload to this section of the site.

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