Requirements for HMO Application: Health Card For Yourself

With the rising cost of hospitalization, you’ve probably realized that having a reliable health coverage is necessary. Now that you are planning to get a health card, it is time that you know the basic requirements to get one.

How to Apply for a Health Card

As an individual, how can you actually get a health plan from HMO companies?

There are two ways to get a health card. One is being an employee and the other is buying one yourself. Most private companies in the Philippines provide at minimum benefits of health care coverage. This is a part of employee benefits and can be arranged by the company itself.

On the other hand, a private individual who wants to get covered by an HMO will have to personally apply and even add family members to the account if possible.

We are going to talk about the second option which is individual application. You see, HMO companies are similar to health insurance. They want to minimize the risks of them paying for your medical bill. In such a case, a set of requirements may be applied to you before you can be accepted into the program and be covered.

Application Form

Individual health card applicants now has an easier way to apply online thanks to the internet. You can browse through the various HMO companies and simply fill out the form online and submit.

Just make sure that you fill out the details with the best of your knowledge so your application will be processed faster.

Check Up Evaluation

Some companies will require that you submit medical certificates or results to evaluate your application. HMOs do not want to accept people who are already sick as they may be liable for more expenses.

This is where medical evaluation comes in. Preliminary check up and paper work needs to be satisfied before they will approve your application. What are the required medical tests? The usual tests include but not limited to the following:

• Chest X-ray
• Blood test
• ECG
• Urinalysis

In our experience, Medicard for example requires that you go to the nearest medical clinic in their network to get evaluated. They have resident doctors and staff to assist you. Medical check up may be required especially based on the age of the applicant. For example, 40 years old and above are required to undergo medical tests.

Can I use my recent medical tests and exams from other clinics? You may show them but they will usually be rejected since they you to have results coming from their own clinics.

Do I Need to Pay for Preliminary Check Up?

Yes, you will personally pay the medical evaluation of HMO for your application. This may range from Php 800 to Php 1,200 depending the the company. Note that the amount you will pay will not be reimbursed after your application is approved.

Payment of the Premium

One last requirement is of course to pay the annual membership. The company will initially notify you once your application is approved. You will be given instructions on where to pay. Usually, you can do this over the counter at their business centers. Some HMO companies however allow for bank payments, fund transfers and even e-wallet payments.

If you wish to have the payment in installments, you can simply use your credit card and convert the amount from 6 to 12 monthly payments whatever is convenient to you.

Is it possible to get denied?

There are instances when health card applications are denied due to various reasons. One example is the member already has pre-existing conditions that are too critical to be handled by HMO companies. On the other hand, some companies will need you to undergo certain tests to see if you can still be accepted to the program.

When Can I Use My Health Card?

There is usually a grace period before you can start using your account. The company will tell this detail to you in the contract. In most cases, the waiting period is from 1 week to 30 days depending on the plan you availed.