If you don’t have healthcare, is your savings is enough to cover your medical expenses? Or you need to borrow money? To most people, they consider healthcare as an additional expense. But to the wealthy people, they consider it a good investment.
What Is A HMO?
The Health Maintenance Organization or simply HMO is a network or organization that provides or arranges health services to its members through its network – doctors, dentists, hospitals, and clinics in exchange for a membership fee. HMO subscribers can pay the contract price monthly, quarterly, semi-annually, or annually.
It operates as an intermediary between you as a member and to its network of providers. It differs from other types of health insurance in a way that the HMO will directly pay your medical bills or services to its accredited healthcare providers instead of giving you cash. Through HMO, you can have coverage for a broader range of preventive healthcare services compare to another type of plan.
Short-term VS Long-term Healthcare
Many people are comparing short-term HMO and long-term HMO. The main difference is a short-term HMO is designed for immediate consumption. The benefits are either you use it or you lose it. An example of this is the healthcare provided by the companies. On the other hand, long-term HMO is designed for future use.
Here is a comparison between the traditional HMO and the long-term HMO (Ultimate Kaiser Health Builder).
Why You Need A Long-Term Healthcare
If you are employed, chances are you are covered with the health insurance provided by your company. And that’s a good benefit since it can really help you whenever you need some medical care. However, in the long run, this may not be enough. Why? Since it can be availed only while you are still working in your company. When you retire or resign, you will lose that benefit.
The following are some of the reasons why you need to have one.
- ) You cannot bring with you the healthcare benefits provided by your company when you resigned or retired.
- ) Most sickness appears during your retirement years.
- ) Healthcare is very expensive at old age.
- ) Medical costs double every 5 to 7 years.
- ) Hospitals may not let you get admitted when you do not have an initial down payment.
- ) The Majority of Filipinos do not save money for their future healthcare needs.
- ) No traditional healthcare company covers ages 61 and up.
- ) Most people rely on their children, selling properties, or borrowing money for their medical needs in their retirement years.
- ) One of the major reasons for bankruptcy is due to a medical crisis.
About The Company
Kaiser International Health Group, Inc. is registered as a healthcare provider. The company was incorporated and registered with the Securities and Exchange Commission on June 8, 2004, with an authorized capital stock of Php 160M. It was also granted a clearance to operate by the Department of Health – Bureau of Health Facilities and Services last July 26, 2004. The same government agency that regulates and supervises health maintenance organizations. The President and Medical Director of Kaiser International Healthgroup Inc. Is Dra. Leah Uy-Yolo who also received an award as one of the Outstanding Thomasians in the year of 2019 in the field of Medicine.
Vision And Mission
“We shall aim to be the industry leader in providing maximum, long-term and short-term health care benefits to all our members.”
“We help build a secure future and wise financial foundation in coping with inevitable medical expenses each of us would one day face especially after employment and during retirement years.”
You can visit the official website here.
Exclusive Broker
The International Marketing Group (IMG) is the exclusive broker of Kaiser International Healthgroup Inc. It is a brokerage company that primarily helps to spread financial literacy to the Filipinos. The IMG offers access to different financial products and services through a partnership with the leading companies.
Meet The Ambassadress
Sharon Cuneta-Pangilinan is the Ambassadress of Kaiser International Healthgroup, Inc.
Kaiser Medical Center
The Kaiser International Healthgroup, Inc. has its very own medical center aside from its network of accredited healthcare providers. To provide quality medical services, the company continues expanding to accommodate the Filipinos nationwide. Currently, here are the branches.
What Is Ultimate Kaiser Health Builder
Kaiser’s product is designed to address your long-term healthcare needs, especially after your employment and during your retirement years. The Ultimate Kaiser Health Builder is a 3-in-1 health savings program, which is the first of its kind in the country, that caters to the 3 basic financial needs – investment, life insurance, and healthcare.
The product has three periods, (1) Accumulation Period, (2) Extended Period, and (3) Long-term Care Period. And in each period, your benefits will have some changes. Now let us discuss them individually.
Accumulation Period
The accumulation period is a 7-year paying period wherein the policy owner will pay the premium. The premium will depend on the type of policy plan and can be paid annually, semi-annually, quarterly, or monthly.
Benefits and privileges:
1.) Annual Physical Exam (APE)
2.) Basic Dental Benefits
3.) Basic Medical Benefits
4.) Waiver Of Installments Due To Death or Total Disability
5.) Accidental Death and Dismemberment
6.) Choice of room and board
7.) Term Life Insurance (20 years)
8.) Annual Benefit Limit
9.) Family assistance
You can start to avail of the benefits mentioned above if you were able to pay equivalent to a one-year premium (one annual payment, two semi-annual payments, four quarterly payments, or 12 monthly payments). And your policy is in good standing meaning it is in force and not lapsed. You just need to contact Kaiser to set an appointment on the accredited hospitals or clinics.
The pre-existing conditions are not yet covered within the 7 years paying period. That is to protect the healthy plan holders and the company. It is more focused on preventive healthcare. The out-patient benefits like consultation are not also covered this time and will be covered only during the extended period.
Your annual health benefit limit is your available fund that can be used in case you will get hospitalized. You can use this within the accumulation period. But, if you used it even once you will no longer qualify for the long-term care bonus. A long-term care bonus is equivalent to 85% of your total premium (contract price). Take this like a “refund” or a way of “thanking” you for taking care of your health.
For the term insurance and other insurance benefits, it will take effect upon the approval of the insurance component. This will usually take 2 weeks.
Do not be afraid or hesitant to avail of the Annual Physical Examination as well as the dental benefits since it is free and it will not affect your other benefits in the future like the cash value or maturity value.
For the Family Assistance, it is subject to approval since it is just accommodation and not totally considered as a benefit of the plan. If one of your immediate family members needs to be confined, you can request to extend your Kaiser Healthcare Plan.
In order to be able to qualify for Family Assistance. Here are some conditions that you should meet:
- The policy should be active and completed at least 1 year of payment.
- Immediate family member only.
- Avail only to accredited doctors and affiliated hospitals.
- Assistance shall only be the extent of the allowable benefits of the policy.
- Prior to discharge, payment should already be settled with Kaiser.
- Approval of assistance must be first obtained by the member and the issuance of LOA will be given.
Extended Period
The extended period or waiting period covers the 8th year to 20th year and during this period, you will no longer pay the premium. Instead, the Kaiser will pay you back through annual health benefits and additional health benefits. Again, the value of annual health benefits and additional health benefits will vary depending on the plan type.
The pre-existing illnesses and dreaded diseases are now covered by your policy unlike during the accumulation period. Both the outpatient and inpatient are also included. But, the annual physical examinations are no longer free. All costs will be deducted from your health fund.
Benefits and Privileges:
1.) Outpatient
2.) Inpatient
3.) Pre-existing illnesses
4.) Dreaded diseases
5.) Maternity
6.) Term Life Insurance (20th year)
7.) Accidental Death and Dismemberment (20th year)
8.) 10% Annual Health Benefit
9.) Additional Health Benefits (Yearly Bonus)
In the extended period, all of the money in your health fund are consumable but limited to healthcare-related expenses and services only. And Kaiser will give you an annual health benefit and yearly health bonus. Let say that for this year, you totally consumed your health fund. In the following year, it will be replenished. But, if you were not able to consume your health fund, it will earn interest.
Bear in mind that the annual health benefit is guaranteed except for the additional health benefits (yearly bonus). The AHB will depend on the actual performance of the investment which is mostly liquid investment like mutual funds.
Long-Term Care Period
The long-term care period covers beyond the 20th year and will end only if you take out all of your money in your health fund. This time, you will receive a free visa card wherein your health fund will be deposited and can be accessed at the same time.
During this period, you can withdraw your funds. You have the option to withdraw your money all at once, withdraw it yearly like a pension or just leave it. As long as there are remaining amount in your health fund, it will continuously earn an interest. When the insurer died, all of the remaining money will be transferred to the beneficiary.
Benefits and Privileges:
1.) Total accumulation of unused health benefits
2.) Long-term care benefit
3.) Long-term care bonus (up to 85% of premium contributed)
4.) Additional Health Benefits (depends on the market)
5.) Good as cash (withdraw all of your money, a portion, invest)
You will get a refund of 85% of the total premium (long-term care bonus) of your plan if you were not able to utilize the Annual Benefit Limit (ABL) during the accumulation period (7-year paying period). Again, if you used it even once, you are no longer qualified for the long-term care bonus. That’s why it is recommended to use the short-term HMO provided by your employer if you have any.
Frequently Asked Questions
Who are the clients of Kaiser International Healthgroup Inc.?
Among the many clients of Kaiser International Healthgroup, Inc. is the House Of Representatives. Refer to the memorandum (screenshot only) below. This proves that the company has a good reputation since it is the Philippines’ government officials who are being catered.
You can download the full memorandum in their official website.
What are the accredited hospitals and clinics?
There are many accredited hospitals and clinics nationwide. You can check the full list in their official website.
Is Kaiser International Healthgroup, Inc. legit?
The Kaiser International Healthgroup, Inc. is accredited by the Insurance Commission as a Health Maintenance Organization (HMO) with a license number HMO-2017-04-R. It is also one of the proud members of the Philippines Association of HMO Companies (PAHMOC).
How stable is the company?
The initial authorized capital of the Kaiser company is Php 160M which is too way high from the required. Aside from that, Kaiser owns the majority of the shares of the Soldivo Funds which are among the top-performing mutual funds in the country.
Can I can cancel and terminate my plan and get a refund?
You can cancel your plan within 30 days from filing your application and have a full refund given that the life insurance benefit was not used.
What if I do not have now the capability to continuously pay my policy?
If you cannot pay the premium before your due date, you have a 60 days grace period. You will not have any penalty if you can pay within that period. However, if you were not able to pay within that time frame, you can still reinstate your policy so that your previous payments will not be totally diminished. You should reinstate within 2 years from the date of the first unpaid premium to avoid lapse policy. Kaiser shall cancel the contract without the need to inform you if you fail to reinstate your policy within the prescribed period.
There are two options to reinstate your policy:
- Update. The policy owner will pay all the unpaid premiums and a surcharge of 1.5% per month or 18% per annum and a reinstatement fee.
- Redate. The policy owner can choose to pay only the premium and a reinstatement fee but the date of maturity will be moved.
Another option is the Cash Surrender Value. The policy owner may surrender the contract for its cash value stated in the Schedule of Benefits provided the Plan is active for at least two (2) years.
Can Oversees Filipino Workers (OFW) apply for Kaiser Healthcare?
Yes, OFW can apply. In fact, there are many OFWs that are Kaiser policy owner. You can apply here online or to view a sample quotation.
Is my family also covered in my policy?
No, it is an individual policy, not a family package type. It only has a family assistance service and denial or approval will solely depend on Kaiser Management Evaluation.
What Are The Plans Available?
Starting at 10 years old up to 60 years old are eligible. And the premium will depend on the age bracket also. You will also have an annual policy fee of Php 500 or Php 3,500 for spot cash.
- 10 – 40 years old K45 or higher (starts at Php 2,647/month)
- 41 – 50 years old K60 or higher (starts at Php 3,529/month)
- 51- 60 years old K75 or higher (starts at Php 4,412/month)
What are the different mode of payment and can I change it?
You have an option to pay monthly, quarterly, semi-annually, or annually. There is a two months discount if you opted to pay the premium annually, and a one-month discount for semi-annually. For spot cash, you will also have a different computation. Yes, you can change your mode of payment anytime after completion of its respective cycle. However, it is only applicable if it is an upgrade (from monthly to quarterly to semi-annually and so on) and not vice versa.
Can I change my plan type?
Yes, you can change your plan type within 30 days only from the effectivity date of your plan. And only an upgrade of the plan is allowed.
Can I withdraw from my policy?
You can only withdraw after the maturity period (after 20 years) from your health fund.
How can I check the investment part of my policy?
Remember that you invested in the Kaiser product and not directly on the investment vehicle like on mutual funds. Your investment is the accumulated heath benefits which are guaranteed to have positive growth. You can request a statement regarding the available balance in your health fund after the 7th year.
How long is the contestability period?
The contestability period means if the insurer dies within the time-frame the company has the right to conduct an investigation and can deny the claims depending on the result of the investigation. It is a way of protecting the company from any misrepresentation of information on the insurer’s application and any fraudulent claims. It begins as soon as the policy takes effect. For the Ultimate Kaiser Health Builder, the contestability period is 2 years.
If the members need some assistance, what are the support hot lines or contact numbers?
For updated details and information, you can visit the full list of hot lines and contact numbers here.
Do I need to become an International Marketing Group (IMG) member before I can avail the plan?
You are not required to become an IMG member in order to be able to avail of the Kaiser plan. Additionally, the exclusive broker is the International Marketing Group (IMG). Hence, you can avail a Kaiser plan through its members.
How can I check my policy online?
You can access your policy online through Online Policy Management System (OPMS). In your OPMS account, you can view your contract, benefit card, history of payment, and scanned copy of official receipts.
What are the ways to pay my policy?
You can pay on any IMG bank accounts or to any Kaiser International Healthgroup, Inc. bank accounts through online or by personally depositing in the bank. Another option is through bills payment on your online bank account particularly BDO and BPI. Or through your GCash account and Palawan Express.
Can I use my Kaiser policy outside the Philippines?
No, you can only used it within the country and on accredited hospitals, clinics, doctors and dentists.
Why We Recommend The Ultimate Kaiser Health Builder
It is a good starting point especially for those who are just started building their financial foundation. A financial product that covers your three major financial needs – healthcare, life insurance, and an investment. This is valuable for you if you do not have the luxury to buy the three products separately.
Why it can be considered as a good initial investment? It answers the many IFs in our life.
What if I die too soon? It has an insurance component. Your beneficiaries can claim the life insurance benefit. The amount will depend on the plan type you availed. It will be doubled if it is an accidental death. The premium also will be waived (fully paid) and the benefit will be transferred to your beneficiary. Your beneficiary can enjoy the other health benefits.
What if I got totally disabled? Since you do not have the capacity to work in order to earn. You do not need to pay the premium, it will be waived (fully paid). You will also receive cash benefits.
What if I always get sick? We know that it is costly. In order to compensate your expenses, you can avail of the annual health benefit limit within the seven years. The expenses will be deducted first from your Philhealth (if you have any) before from your policy.
And what if I live too long? You do not need to worry about your expenses. Upon maturity, you have three options. You can withdraw all of your money (entire maturity value) at once, withdraw just a portion from it when you need some money, or just leave it. As long as there is still some remaining money in your account, it will continue to earn interest.
No matter what will happen, you can make use or maximize the Ultimate Kaiser Health Builder. If the Lord takes you, your family will receive cash and the policy will be transferred to your beneficiary. And if you will have a long life, you are the one to enjoy the benefits.
Bottom Line
Preparing your future as soon as possible is a great way to be financially at peace. Since our future is full of uncertainties, it is better to be always prepared. And that will happen only if you are able to provide a solution in any situation that may arise.
And the Ultimate Kaiser Health Builder is a good initial investment product that can provide the three major financial needs – healthcare, life insurance, and an investment. Though it does not guarantee that you will be fully equipped in all financial aspects.
Remember, before you avail of any insurance products, make sure that you know your purpose. Be mindful of why you will avail the product. Does it suit your needs? Does it align your goal? Do you have the capacity to pay the premium? Just like any financial product, you need to take good care of your policy also.
As an additional tip, it is recommended to buy health care, or any insurance products, while you are young and healthy and able to pay. Availing an insurance product while you are young is cheaper and the chance of your policy being approved is high.
If you want to learn more about the Ultimate Kaiser Health Builder, you can check it here for a more detailed presentation. Or you can get a sample quotation here.
Disclaimer: The presentation about the Ultimate Kaiser Health Builder does not necessarily reflect the company, the Kaiser International Healthgroup, Inc.
