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Pman

Good health insurance in philippines?

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enoonmai

They will try to weasel out of any serious claims. I'm not talking about sprained wrists or dodgy tummies here. Health insurance should really be for the catastrophic incidents. If you rely on a Philippine health insurance company for this you will be sorry. Unfortunately it will be too late for you then. Go with a major international company that specializes in expat situations and should be tailored to your country of citizenship should you want to include emergency repatriation coverage. Don't be fooled into thinking Blue Cross Philippines is a 'major international company' either. It all sounds great in their brochures, but when it matters most, you will be sorry.

Has Blue Cross Philippines ever made a public claim that they are a "major international company"? The Company Profile on their website doesn't say anything like that.

 

You have stated several times on this forum that you have had bad experiences with Blue Cross Philippines. Other posters (me included) have commented that their experiences with this company have been overall positive. My experience is limited, I have had 2 claims in 5 years for inpatient stays. All bills except some incidentals were paid in full, either by direct billing to the company or reimbursement to me by check within 15 working days. That’s not to say that there were no problems; there were, but both times the BC rep came to the hospital and personally straightened them out. I’ve never even filled out a claim form.

 

This is an important topic. It would be helpful if you could share some specifics of your personal experience with Blue Cross Philippines in general terms, not private medical information. My family and I still have one of their top tier plans (inpatient only) - even by western standards it’s not cheap. If there is a real problem with this company paying legitimate claims it would be helpful to hear specifics.

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Monsoon

 

 

My experience is limited, I have had 2 claims in 5 years for inpatient stays. All bills except some incidentals were paid in full, either by direct billing to the company or reimbursement to me by check within 15 working days. That’s not to say that there were no problems; there were, but both times the BC rep came to the hospital and personally straightened them out. I’ve never even filled out a claim form.

 

How much was the total of these claims?
 

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Jawny

I don't know why its so hard to understand. If you only have Philheath and nothing else, and do not have the cash money to pay for operations, drugs, other treatments etc.. you will DIE. They will let you DIE. They will not do ANYTHING until you pay. 

 

Philheath pays and helps when the bill is due, NOT before.

I know that Philhealth has some limitations. However, it will be of assistance for LinC members who have limited resources for health care. It is extraordinarily cheap to buy, but that does mean you get what you pay for. Some members have reported good experiences with getting their medical bills paid using Philhealth. If Philhealth is available, an individual can be admitted to a hospital and treatment begun with no cash required. Of course, this does not last long if the treatment is extensive and there are medications necessary. The patient can be expected to buy their own medications at some point in the care being provided. Many times the surgeries are discounted to match Philhealth coverage so the patient ends up only responsible for medication costs. There are treatments and procedures Philhealth has approved for specified amounts. Sort of package deals.

 

I've not heard of any patients dying while using the benefits of Philhealth. I do know many families with large bills to pay after discharge and Philheath coverage is completed.

 

I use a USA based insurance and it requires me to pay first and claim later.

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Monsoon

 

 

This is an important topic. It would be helpful if you could share some specifics of your personal experience with Blue Cross Philippines in general terms, not private medical information. My family and I still have one of their top tier plans (inpatient only) - even by western standards it’s not cheap. If there is a real problem with this company paying legitimate claims it would be helpful to hear specifics.

 

The long and short of it: I was wrongfully diagnosed with a condition. Admitted to the hospital. BC Phils representative cried "Preexisting condition!"

 

What preexisting condition? They haven't diagnosed me yet! 

"Umm ohh, umm.. You are new to Blue Cross, right?" 

 

"Umm ohh, You haven't been in the hospital for more than 48 hours yet!"

 

Found every excuse not to pay. 

 

Guess what? There was nothing wrong with me, it was a pinched nerve and nothing to do with my cardiovascular health. 

 

BC Phils is  sham. 

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Monsoon

 

 

have had 2 claims in 5 years for inpatient stays.

 

Also didn't you say before that your claim was due to an accident? It is pretty hard to label and accident as a preexisting condition, although I'm sure they would if they could. 

 

I need health insurance coverage that I can depend on for the serious catastrophic things, not accident insurance. 

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enoonmai

Also didn't you say before that your claim was due to an accident?

The 2011 claim was the result of a bike accident. You asked the total bill, I don't know because there were numerous payments made; some direct-billed to the insurance company, some paid by me and reimbursed. A guesstimate would be in the neighborhood of p2 million, maybe more. The 2013 claim was a short stay at South Gen for our child for an infection. Was p20k something as I recall, direct-billed to BC. I believe we also used Philhealth that time. Sorry to hear about your experience with this company. There have been numerous other posts made about Blue Cross Philippines and I think your's are the only negative ones I've seen.

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aussiekangaroo

The long and short of it: I was wrongfully diagnosed with a condition. Admitted to the hospital. BC Phils representative cried "Preexisting condition!"

 

What preexisting condition? They haven't diagnosed me yet! 

 

"Umm ohh, umm.. You are new to Blue Cross, right?" 

 

"Umm ohh, You haven't been in the hospital for more than 48 hours yet!"

 

Found every excuse not to pay. 

 

Guess what? There was nothing wrong with me, it was a pinched nerve and nothing to do with my cardiovascular health. 

 

BC Phils is  sham. 

 

How long were you a member before your hospital stay?

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senseless

BC ph will cover [some?/all?/most?] pre-existing conditions after 1 year. They did the same for my wife about a condition she has which is genetic. They're now paying for the condition.

 

I have the paper somewhere that says this but I can't seem to find it at the moment. Never had anyone in the hospital crying foul though. Sounds like the agent that was assigned to his case was new and/or stupid.

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enoonmai

BC ph will cover [some?/all?/most?] pre-existing conditions after 1 year. They did the same for my wife about a condition she has which is genetic. They're now paying for the condition. I have the paper somewhere that says this but I can't seem to find it at the moment.

If you can find it I would love to see it because I find it hard to believe they would put that in writing. The verbiage I have seen is along the lines of "each case is evaluated on an individual basis". And there is an appeal process.

sounds like the agent that was assigned to his case was new and/or stupid.

Agreed.

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Monsoon

 

 

The 2011 claim was the result of a bike accident.

 

Yes, as stated previously, it is pretty hard to label an accident as a preexisting condition. 

 

 

 

Was p20k something as I recall, direct-billed to BC

 

They are good at paying the small bills. In my incident the bill was up over 100k within the first 12 hours due to tests ordered by the doctors. 

 

I know what I experienced and what I witnessed told me all I need to know about BC Philippines. I could not count on them for the security of my family. If a major health problem surfaced they would do what they could to get out of it. One rarely has the luxury of time for 'appeals processes' and who do you think makes the decision during an appeal? The same people who deny you in the first place. 

 

Health insurance for me is only for the major things. I don't care about 20k-100k peso bills. It is for things that would require $20,000+ that I am concerned with. If having their card in your wallet makes you feel secure then that's great. But when the chips are down, they will do what they can to weasel out of covering you. Personally that was not very comforting for me. 

 

 

 

How long were you a member before your hospital stay?

 

Nine or ten months. 

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senseless

If you can find it I would love to see it because I find it hard to believe they would put that in writing. The verbiage I have seen is along the lines of "each case is evaluated on an individual basis". And there is an appeal process.

Agreed.

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