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Medical Tests That Your HMO Covers

We all hate medical tests since they are expensive. Before you apply for a health card, see which medical tests are covered by HMO companies.

Health cards may cover any of these tests as long as an accredited doctor recommends them.

  • 2D Echo and Doppler
  • Angiography
  • X-Ray
  • Pulmonary Perfusion Scan
  • Ultrasound
  • Endoscopy
  • Colonoscopy
  • CT scan
  • Mammography
  • MRI
  • Myelogram
  • Treadmill Stress Test

The price of the plan will determine the medical services once the doctor has a prescription for them. In most cases, there will be coverage for medical tests the higher the plan rate is.

We’ve listed here some of the best HMOs that can cover a part or the whole amount of your medical diagnostic tests.

Medicard

Covered medical tests of Medicard include CT Scan, MRI, Ultrasound and X-ray just to name a few. They may have limits of Php 5,000 per member per year for pre-existing conditions.

Maxicare

Maxicare offer unlimited free diagnostics and consults for their Prima Gold offering. The benefit is valid for one (1) year upon activation of the prepaid health card. There will be more coverage for all other diagnostic tests with doctor’s prescription.

I suppose this is the most cost-effective benefit for those with long-term conditions. My grandparents once had their pre-paid cards and save at total of Php 13,000 instead of paying in cash.

Valucare

Valucare may cover the basics like X-ray and lab tests. Moreover, there is also coverage for specific medical tests such as 2D echo, CT scan and EEG.

For those who may need to undergo lab tests, the doctor accredited by the HMO will be prescribing the specific panels for the patient. The health card can then be used in this case for preventive or for diagnosis purposes.

Some of the most common lab tests covered by health cards include but not limited to:

  • CBC
  • Fasting blood sugar
  • Lipid panel (cholesterol, triglycerides)
  • Urinalysis
  • Fecalysis

In most cases, the mentioned lab tests are free of charge for HMOs with free standing clinics outside of accredited hospitals.

There may be a certain limit coverage of the price for pre-existing conditions apart from the Maximum Benefit Limit (MBL).

Some health cards like Medicard may only be able to cover up to Php 5,000 per member per year subject to pre-existing condition limit.

It is official, Philstar Global specifies in a report that 40% of Filipinos will not be able to pay for medical bills. This is disheartening knowing that each one of us needs to consult a doctor sooner or later due to health concerns. In line with this, even expenses on medical tests may become too expensive for ordinary people.

Just like when using your health card in other ways, you simply need to bring your card together with the doctor’s prescription. In case of emergency situations, the doctor may assist you to get primary service of medical tests in accredited hospitals.

For many health cards, there are limits to the price that they can cover for a diagnostic test. Some are allowed up to the MBL or Maximum Benefit Limit. On the other hand, the usual limit for comprehensive plans is Php 5,000.

Last Updated on October 12, 2024 by pinoyhmo


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