Philhealth, HMO, and Health Insurance: Do I Need to Have Them All?

Saving money for health emergencies is a good habit, but here in the Philippines, this good habit on its own might not be enough.

We’ve heard about the need for PhilHealth, HMO, and health insurance many times before. You have one or two of these, but you’re unsure whether the third one is a necessity.

So, let’s lay down the cards: do you really need to have them all? Let’s discuss.

Philhealth, HMO, and Health Insurance: Do I Need to Have Them All?

First, let’s talk about PhilHealth.

If you are employed in a public or private company, then you are a regular contributor in Philippine Health Insurance Corporation or PhilHealth.

One of the best things about PhilHealth contributions is that it is automatically deducted from your salary, which means it’s one thing off your monthly budgeting. In turn, as an inpatient, you get subsidies from your total hospital bill, including the professional fees of your attending physicians prior to your discharge. There are also numerous benefits for outpatients, which takes off a good amount from your total bill.

The Pros: Freelancers, stay at home moms, and self-employed individuals can also avail of PhilHealth. This will also come in handy when you’re a mom about to give birth.

The Cons: Not all health emergencies are covered by PhilHealth, and the subsidy may only be a small percentage of your total medical bill.

The Caveat: As a government mandate, PhilHealth’s policies are subject to change, just like how the 2023 4% contribution increased to 5% this year..

Then, let’s discuss how HMO complements PhilHealth.

If you are a regular employee, one of the benefits you may enjoy from your company is a membership to a Health Maintenance Organization or HMO. An HMO gives you access to their accredited doctors and hospitals without having to worry about shouldering a hefty medical bill.

PhilHealth and HMO are not mutually exclusive. This means that you may use both of them to help you further lessen the amount you need to take from your pocket in a medical emergency.

The Pros: HMO is a good safety net for health emergencies. If you are a freelancer or a stay at home mom, you may look for HMO that offers individual packages.

The Cons: You will have to read, ask, and research well to be able to find an HMO coverage that will respond to your and your family’s needs.

The Caveat: Some hospitals implement cut off time for using HMOs, and accredited doctors may not available in the hospital nearest you.

Let’s now take a closer look at having a separate health insurance.

When you have a comprehensive health insurance policy, you are protected from having your lifetime savings drained due to hospitalization, retirement, and death. Compared with PhilHealth and HMO, you may be paying more for your monthly insurance premium. However, its benefits outweigh the cost as it can cover accidental death and disablement and critical illness.

The Pros: You may customize your insurance policy based on your budget and needs. Some of these even have an investment component that allows you to grow your money while you’re being protected from life uncertainties.

The Cons: Health insurance policies may or may not cover a very specific health emergency. Better ask your financial advisor for regular updates to your policy.

The Caveat: Since your insurance premium may form a significant part of your budget, you may have to ready your emergency fund so you can continue paying for it in case an unexpected turn of events occur.


What has been your family practice in responding to health emergencies, and how can you better improve it? Share your thoughts with us in the comments section!

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