What Do You Get Out of Paying for HMO for Your Outsourcing Staff?
10 Apr

By Claire Ponsaran | Posted on April 10, 2017 at 6:41 AM 0 Comments

While it's normal for people to get sick once in a while, there are common factors that negatively affect the health of your outsourcing staff in the Philippines. These factors include working at night and sleeping less, environmental pollution, workplace stress, and an unhealthy lifestyle. The negative impacts of these factors on employee health can be reduced and managed well through universal healthcare services. Find out how healthcare is provided for in the Philippines and the deeper reasons why it's important that you pay for HMO for your employees early in their tenure.

PhilHealth and Universal Healthcare

The World Health Organization (WHO) defines universal health coverage (UHC) as a compendium of promotive, preventive, curative, rehabilitative and palliative health services that all people and communities have access to whenever they need them. These services should be of sufficient quality to be effective, while also ensuring that their continued use does not expose the user to financial hardship.

WHO considers healthcare as a fundamental human right. And, this is the reason why PhilHealth (PHIC) was created through Republic Act 7875 or the National health Insurance Act of 1995. PHIC is an attached agency of the Department of Health (DOH). DOH has expanded the coverage to include chronic diseases, such as asthma and arthritis, and catastrophic cases, such as severe burns, heart attack or stroke, and brain injury.

Other Ways to Receive Healthcare Services in the Philippines

It's important that we delineate between public and private health insurance. Public insurance is provided by PhilHealth or the Philippine Health Insurance Corporation (PHIC), which is a government-owned and government-controlled corporation. Private health insurance is provided through HMOs, and other medical insurance providers.

Basic healthcare is provided by PhilHealth to mostly indigent patients. To greatly reduce financial risk on indigents, PHIC has a No Balance Billing (NBB) policy for hospitals and clinics. The policy states that no other fees or expenses shall be charged to or paid for by the indigent patient above and beyond the package rates.

For the best possible health outcomes, private corporations choose to pay for HMO services on top of the PHIC, SSS and HDMF contributions they're paying for their employees. HMOs have a nationwide network of healthcare professionals and organizations that provide preventive as well as palliative care to their members. Those who are enrolled can take advantage of reduced rates for medical check-ups, laboratory services, and dental care when they visit a clinic or hospital that's a member of the HMO network.

For self-employed or contractual workers, they may voluntarily pay their monthly dues to PhilHealth and SSS, or they can pay for their medical needs through an insurance company, such as Philamlife or Manulife.

The insurance company either pays directly to the healthcare provider, or the individual pays out-of-pocket first and then files for reimbursement later. However, the amount reimbursed will depend on the limits of the plan. For example, if the plan only covers 50,000 pesos in total expenses, but your actual costs amounted to 100,000 pesos, only half of that may be reimbursed by the insurance company.

Paying a monthly premium for health insurance can be expensive for both the patient and the employer. One way of controlling the costs is to buy prepaid health cards from HMOs like MaxiCare and MediCare.

Some cards commonly provide emergency room coverage only while others include a brief hospital stay (overnight or two days, at most). Buying a prepaid health card is magnitudes cheaper than paying for insurance each month. But, the problem is patients don't have comprehensive healthcare coverage and certain illnesses are excluded.

Why Pay for HMO for Your Outsourcing Staff?

It's normal for Filipinos to get sick from the common flu. The highly humid, wet and polluted environment is conducive to bacterial growth. Small wounds often get infected when they're not properly cared for. And, mosquito-borne as well as water-borne diseases such as dengue and leptospirosis are pervasive in the Philippines.

Absences because of these illnesses can be a problem to you. Your operations may be stalled if you can't find someone to replace your ailing staff. Most of the time, your employee will be forced to incur debt just to pay for the medicine and other necessary expenses.

Also, expect his or her co-workers to pass around a donation box to raise funds to help their friend. While this is a beautiful display of heartfelt sympathy towards their fellow man or woman, your employees don't need to ask for donations from others just to help. As their employer, it's your duty and responsibility to take care of your people.

And, one of the ways you can help them avoid getting sick unexpectedly is to provide preventive healthcare through an HMO. Your employees will have immediate access to comprehensive healthcare services without worrying about where to get the money to pay for them. Most medical and surgical procedures, and even hospital confinement, are covered aside from the checkups, dental care, and laboratory services.

What's even better is that you and your employees can save a lot of money because members can use their HMO privileges along with PhilHealth's services. PHIC may cover around 15% to 30% of your medical and hospital costs. The remaining balance will be paid by the HMO provider.

Lastly, providing healthcare through HMO is an effective way of attracting top talent and convincing your employees to stay. Offer something as basic as HMO and your company will remain globally competitive.


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Tags: offshore outsourcing, offshore outsourcing tips, employee wellness

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