Heart Surgery Coverage of HMOs

For most people, heart surgery becomes a burden especially that it is expensive. Is there an HMO that includes heart operation? Let’s take a look at your options.

Maxicare

The company offers coverage for heart surgery but not in a direct way. You as a member can initially benefit from its consultation with a cardiologist.

If you are a candidate for surgery, the room and board will be covered up to the MBL (maximum benefit limit). However, an ambulance service benefit is up to Php 2,500, especially for critical emergencies.

Medicard

If you will avail the comprehensive plans, for sure the company can cover your confinement after a heart surgery. It will also have a separate benefit for the professional fees of the surgeon and anesthesiologist.

This will also mean that room and board is covered according to your plan’s limit. What I noticed is that the prepaid cards that you can buy online exclude almost all heart procedures.

For example, even the VIP health card indicates “Open heart surgeries, angioplasties, valvulaplasties, permanent pacemaker insertion”.

Philcare

While info about surgery coverage is still not available, Philcare has a good coverage for cardiovascular diagnostic procedures. This is essential if you are starting to have symptoms that relate to the heart.

The company has many prepaid offers that may suit your budget limits. Try to compare its offers when it comes to preventive medical benefits.

Expenses covered by health cards

As always, major surgeries will involve the following expenses:

• Operating room
• Surgeon’s fees
• Room and board fees
• Ambulance or ER expenses

What are the common heart procedures?

Heart Bypass: treating the buildup of plaques in the artery, also known as coronary artery bypass surgery

• Transplant: a critical surgery that transplants a donor’s heart to the patient
• Angioplasty: removing the blocked substances in the artery using a balloon
• Aneurysm in the heart: repairs the swollen part of the aorta that may rupture or tear

How to choose the best HMO for heart surgery?

Initially, you may narrow down your choices to affordability. The presented companies here have some of the best value for money offering if heart surgery is to consider.

Coverage for the doctor’s fee is important as well as the operating room use. If you will avail a higher tier plan, you can expect the room to be covered as well. Look at plans that cover at least Php 250,000 and you can manage other expenses later.