HMO (Health Maintenance Organization)
Health
A private health plan, often provided as an employee benefit, that covers medical services through a network of accredited hospitals, clinics, and doctors. Members typically present an HMO card for consultations, laboratory tests, emergencies, and hospital confinement up to a maximum benefit limit. Coverage rules, accredited providers, and exclusions such as pre-existing conditions vary by plan. HMOs are separate from PhilHealth and often work alongside it, with PhilHealth applied first. Individuals and families can also buy plans directly. Benefits, limits, and coverage are subject to the latest rules/guidelines.