HMOs are helpful in providing affordable health medical services, so you can receive the care you need without breaking the bank. Fortunately, the Philippines has various HMO providers offering a range of coverage and benefits. To help you find the right plan, here’s our list of the top HMO providers in the Philippines.
Table of contents
What is an HMO Plan?
A Health Maintenance Organization (HMO) plan is a type of health insurance that provides its members with comprehensive medical services for a fixed monthly or annual fee. In the Philippines, an HMO often complements PhilHealth coverage, meaning, you can use this plan to cover a percentage of the cost during medical emergencies.
One of the advantages of having an HMO plan is it gives you access to its network of healthcare providers, including doctors, hospitals, and specialists. However, you need referrals from their accredited doctors to access specialists or medical procedures. Most companies will provide HMO as an additional benefit to their employees, but individuals or families can also apply for one.
What’s the difference between an HMO and an insurance plan?
An HMO and insurance plan provide access to healthcare services and help manage costs. However, for an HMO, you can only choose a primary care physician and acquire medical services from the HMO’s networks. In addition, HMOs often have lower premiums and out-of-pocket costs than traditional insurance plans.
Top HMO Providers in the Philippines
If you’re looking for a reliable HMO provider in the Philippines, here are our top recommendations for companies that offer individual plans:
Maxicare
Maxicare Health Corporation was established in 1987 by a group of doctors and businessmen aiming to provide better healthcare. Since then, they have continuously progressed to become the top HMO providers in the country.
Here’s an overview of their MyMaxicare HMO plan that’s aimed at individuals and families:
- Coverage – Full coverage
- Inclusions – Access to inpatient, outpatient, preventive, and emergency care
- Additional benefits – 24/7 Telemedicine Teleconsult Voice call, discounts with Maxicare Lifestyle Partners, and therapy for select cases
Plan Types
- Platinum Plus
- Room and Board: Large Private
- Maximum Benefit Limit (MBL) ₱250,000
- Platinum
- Room and Board: Regular Private
- Maximum Benefit Limit (MBL) ₱200,000
- Gold
- Room and Board: Regular Private
- Maximum Benefit Limit (MBL) ₱150,000
- Silver
- Room and Board: Regular Private
- Maximum Benefit Limit (MBL) ₱100,000
Also Read: GUIDE: PhilHealth Hospitalization Coverage and Benefits
MediCard
MediCard Philippines Inc. is one of the leading HMO providers in the Philippines. Incorporated in 1986, they provide comprehensive healthcare coverage to individuals in Metro Manila and select provinces in the Philippines. Here’s what individuals, families, and companies can benefit from their MediCard Select plan:
- Coverage – Full coverage
- Inclusions – Access to various hospitalization, outpatient care, preventive healthcare, emergency care, dental care services, and pre-existing conditions coverage
- Additional Benefits – Waived medical evaluation for members aged 41 years old and above, and maternity benefits
Price List
Individuals without access to 5-star hospitals
| Age | Fund | Annual Access Fee per Member |
| 60 and below | ₱30,000 | ₱3,000 |
| Above 60 | ₱58,000 | ₱3,000 |
Individuals with access to 5-star hospitals
| Age | Fund | Annual Access Fee per Member |
| 60 and below | ₱45,000 | ₱3,000 |
| Above 60 | ₱78,000 | ₱3,000 |
PhilCare
Established in 1982, PhilCare is one of the pioneering HMO providers in the Philippines. The company aims to provide Filipinos with a better quality of life through its world-class health services. Here’s a quick breakdown of their Health 360 program:
- Coverage – Full coverage
- Inclusions – Preventive, outpatient, inpatient, emergency care, dental care, annual physical exam, life insurance, accidental death and dismemberment
Membership Variants
| Room & Board | Maximum Benefit Limit (MBL)/ Annual Benefit Limit (ABL) | |
| Health 360 Private 1.4T 500T | Private (up to Php 1,400.00) | ₱ 500,000.00 |
| Health 360 Private 1.4T 3300T | Private (up to Php 1,400.00) | ₱ 300,000.00 |
| Health 360 Semi-Private 1T 150T | Semi-Private (up to Php 1,000.00) | ₱150,000.00 |
| Health 360 Ward 9H 100T | Ward (up to Php 900.00) | ₱100,000.00 |
Cocolife Healthcare
Cocolife is the first ISO-certified Filipino-owned insurance company in the Philippines. With over 40 years of experience, the company is known for its group insurance plan and as one of the leading healthcare providers in the country.
- Coverage – Full coverage
- Inclusions – In-patient care, outpatient care, emergency services, preventive care, annual check-ups, dental coverage, and financial assistance for accidents and natural deaths
One feature that we like about Cocolife’s HMO plan is members have the option to acquire an unbundled program, where you can select components of the company’s Comprehensive Healthcare Program instead of getting the full package. This allows you to save on costs, especially if you only need to cover a few services.
Here are Cocolife’s options for their Unbundled Programs:
- In-Patient Only – Provides coverage for hospital admission due to illnesses or accidents.
- Outpatient Only – Provides coverage for outpatient consultations, laboratory tests, and treatment for cases that don’t require hospitalization.
- ER Coverage Only – Provides coverage for sudden or unexpected life-threatening situations where a patient needs necessary medical attention.
Also Read: How to Pay Voluntary Philhealth Contribution Using GCash 2024
Kaiser International
Incorporated in 2004, Kaiser International Health Group Inc. was started by a group of Filipino professionals who wanted to provide quality health care to people from low, middle, and upper-class backgrounds. Although the company offers HMOs to groups and individuals, they’re also known for their senior care plan. Here’s a quick peek at their Short-Term Care Plan that’s aimed at individuals:
- Coverage – Full coverage
- Inclusions – Preventive health care, inpatient care, outpatient care, dental care, emergency care
Price List
| Plan Excludes Major Hospitals | Membership Fee | Annual | Benefits |
| Ward up to H- 500 | ₱300 | ₱11,108 | ₱55,000 |
| Semi-private up to H-800 | ₱300 | ₱12,279 | ₱65,000 |
| Small private up to H-1200 | ₱500 | ₱14,810 | ₱75,000 |
| Large private up to H-1900 | ₱500 | ₱22,411 | ₱85,000 |
| Small suite up to H-2600 | ₱500 | ₱26,502 | ₱95,000 |
| Plan Includes Major Hospitals | Membershipfee | Annual | Benefits |
| Ward up to H-1600 | ₱500 | ₱20,073 | ₱75,000 |
| Semi- private up to H-2800 | ₱500 | ₱27,672 | ₱105,000 |
| Small private up to H-3200 | ₱500 | ₱35,077 | ₱115,000 |
| Large private up to H-4200 | ₱500 | ₱49,499 | ₱155,000 |
| Large private up to H-4200 | ₱500 | ₱65,999 | ₱205,000 |
The Final Verdict
Whether you’re an individual or a family looking for the best HMO, the Philippines has various companies that offer a wide range of healthcare plans. However, your decision will come down to your specific medical needs and budget. That’s why we recommend you to assess factors like their coverage or additional services.
But if you want our recommendation, we highly favor Maxicare’s MyMaxicare HMO plan. Out of this list, it offers the highest MBL for its members. Thus, you can get bigger discounts on covered medical treatments. In addition, their package includes additional benefits like access 24/7 to Telemedicine Teleconsult and discounts from Maxicare Lifestyle Partners. So, you’ll get the most out of your investment.
Sources: (1), (2), (3), (4), (5)
Keep Reading: GUIDE: A Comprehensive Guide to Travel Insurance in the Philippines
Leave a Reply