Friday, October 24, 2008

Practicality of HMOs

You often hear people complaining that the doctors they get from their HMOs are no good. Some are too quick to dispense prescriptions without throughly interviewing you first, or you get shunted from doctor to doctor (whoever is available), or you literally have to threaten them before they'd issue laboratory orders.

But maybe all that can be minimized by going for HMOs that do not promise much for so little. You get what you pay for, always remember that, and you have to keep in mind that health insurance is a business. So do not expect to only pay P5k and get the royal treatment.

This is not to say that you should settle for crappy service. But before enrolling in one, review the terms, compare it with other proposals or ideal setups (like maybe, ones like what NC health insurance offers). Is it too good to be true? In home tv shopping speak, are there way too many freebies? Read the fine print. Don't be enticed by extras that you don't really need (pap smears should be standard in a package for a woman in her 30s, but colonics are not). And be willing to pay good money.

Because, at the end of the day, having a health card does save us in medical emergencies. We don't always know when we'd be involved in a car accident or would require an appendectomy. Even the fittest and healthiest can suffer from dengue in our country. A good HMO will take care of the initial, if not all, part of our consultation and hospitalization bills. A bad one will require nurses to triple check, a representative to conduct interviews and make recommendations, a committee to approve, and the injured/sick to come up with deposits or advance payments (supposedly, to be reimbursed after two months or so).

Believe me, you don't want that kind of hassle on top of a medical emergency.

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