Perhaps you've recently changed jobs or gone through a medical emergency. For whatever reason, you're now paying more attention to your healthcare needs than ever before. And you've narrowed your options to health insurance vs HMO (health maintenance organization). Which one to choose?

The short answer is you need both. Your HMO might not cover everything, but your health insurance can compensate for any gaps. You might surprise yourself when you decide to expand your health protection choices after understanding how these two work in tandem.

What Is Health Insurance

Health insurance helps cover some or all medical expenses, but the financial support varies based on the plan you're paying for. One example of health insurance in the Philippines is the government-supported Philippine Health Insurance Corporation (PhilHealth). You can enjoy benefits like discounted medical treatments and prescription drugs in exchange for monthly contributions.

However, Philhealth benefits may not be enough, especially for critical conditions requiring private medical services. That's where HMO comes in.

What Is HMO

HMO is another type of health insurance in the Philippines that offers a network of doctors, hospitals, and medical care services. You need referrals from an HMO-accredited doctor to access specialists or medical procedures.

Depending on your plan, an HMO can help pay for laboratory and screening tests, medical procedures, and hospital room and board. However, these must be conducted within the HMO's network, and each transaction requires approval.

Most workplaces offer HMO as an additional benefit to their employees and dependents. Insurance companies also provide HMO options at different price points to self-employed people.

Different Health Insurance Plans

Members find their PhilHealth benefits valuable as additional monetary assistance during childbirth or an unexpected hospitalization. People with HMO often use the plan for medical check-ups and doctor consultations apart from urgent care. So, health insurance vs HMO need not be a dilemma.

However, your current circumstances may necessitate a more encompassing health insurance with the following benefits:

Flexibility in provider choice

Some health insurance plans have provisions that allow you to continue your established relationships with doctors outside the plan's network. Health insurance plans with excellent coverage often provide a single or lump sum payment that you can use for your preferred hospital or service.

Broad coverage for illnesses

You may be surprised to know there are health plans that cover severe dengue or asthma. AIA Health Cover provides a 25% one-time cash benefit of up to ₱1 million in advance if you're diagnosed with either those two conditions plus 32 other major and minor illnesses.

Additional financial protection

Accidents often exceed your health care coverage. AlA All-in-One provides cash support in case of accidents and disability. Some plans offer daily hospitalization income to use for day-to-day expenses or income loss when you're confined. AlA All-in-One provides you a cash benefit if you're diagnosed with any of the 10 covered major critical illnesses. It also has a life insurance coverage, so your family receives financial support in the event of your passing.

Financial and wellness perks

All AIA health plans come with life insurance at no additional cost, a key benefit if you're the primary family provider. When you're gone, your loved ones can receive a lump sum of up to 45 times your basic annual premium.

Other AIA perks include a 15% discount on premiums during your policy anniversary and membership to AIA Vitality. This science-backed wellness program, the only one in Asia, rewards you for an active lifestyle. You get exclusive discounts from AIA's partners, like gyms, airlines, and hotels, the healthier you become.

Health Insurance vs HMO: Making Your Choice

Selecting a healthcare plan requires a careful assessment of your healthcare priorities, preferred provider relationships, and budget considerations. Private health insurance offers flexibility and coverage tailored to your needs. On the other hand, HMOs provide a more structured approach to healthcare, often with lower upfront costs and a focus on preventive care.

It's not necessarily a matter of health insurance vs HMO. However, knowing the differences can give you the knowledge you need to make smart decisions that match your healthcare needs. Talk to an AIA Life Planner who can help you with your decision-making to put your well-being first. Let's hear it for self-care!