Filipinos who have faced health crises know how healthcare costs can quickly drain their savings. From costly diagnostic tests and treatments to medications and extended hospital stays, the expenses can escalate rapidly, more so if you become critically ill.

Many Filipinos rely solely on their employers' health maintenance organizations (HMOs). But they typically cover routine checkups or a portion of treatment.

HMO plans can fall short of ongoing or specialized care for critical illnesses like cancer or heart disease, which can rack up millions in medical bills. And once the HMO cap is reached, patients and their families often end up using all their savings.

The good news is, there are options beyond an HMO’s standard coverage. To make a more informed decision, let's break down the costs of getting sick and check the gaps in your healthcare coverage.

Every financial expert emphasizes the need for an emergency fund that covers at least six months of living expenses. However, that safety net can vanish in an instant if you face hospitalization or a serious health diagnosis.

In 2018, researchers from UP Manila and the University of the East–Ramon Magsaysay Memorial Medical Center collected data from 21 hospitals to determine how much people typically spend on hospital bills for injuries. Their study showed the results as follows:

• Road injuries: ₱10,000
• Poisoning: ₱4,400
• Burns: ₱6,500
• Animal-related injuries: ₱5,100 
• Other accidents: ₱7,600

Factor in inflation and these medical bills will increase. A medical trends survey by WTW,  a global advisory, broking, and solutions company, projects that medical costs in the Philippines will climb to 18.3% in 2025. WTW predicts this trend will continue in the long term.

Every visit to a doctor for a medical checkup or consultation starts at ₱1,000. If you add lab test or hospitalization, healthcare costs become significantly higher. 

• Laboratory exams, such as complete blood count, urinalysis, and blood sugar, for routine medical checkups, can start at ₱1,500.
• A hospital stay can cost you an average of ₱2,800 per night for a private room.  
• A laparoscopic procedure for gallstones, a common gastrointestinal ailment in the Philippines, can cost ₱68,000 at a leading private hospital, even with PhilHealth coverage.

Non-communicable diseases (NCDs) or non-infectious conditions are the leading causes of mortality in the Philippines today, the Philippines Statistics Authority reports. These health issues usually develop slowly and need ongoing treatment and management.

Below, Medicard, one of the country's leading HMOs, identifies the most frequently diagnosed NCDs in its health network. Ischaemic heart disease ranks as the top cause of death, PSA reports.

• Hypertension
• Diabetes (non-insulin-dependent)
• Gallstones
• High cholesterol and/or triglycerides
• Ischaemic heart disease
• Kidney stones
• Hypertensive heart disease

Monthly maintenance medication for hypertension, a huge risk factor for heart disease, begins at ₱2,500. Coronary artery bypass grafting (CABG), a surgery doctors perform as an emergency treatment for a heart attack, starts at ₱690,000 at the Philippine Heart Center.

Dealing with critical illness, such as stroke, cancer, or heart disease, can hit your finances hard. The average cost of heart disease treatment in the Philippines can quickly reach ₱1 million, from emergency room services to intensive care unit care, according to a report.

Cancer treatment, like immunotherapy, is prohibitively expensive in the country. For instance, trastuzumab, a monoclonal antibody used in immunotherapy, can treat an aggressive type of breast cancer, "HER2/neu-positive." 

One vial of trastuzumab (600 mg/5 mL) costs ₱26,000 based on the Department of Health's (DOH) Drug Price Reference Index. A study says the cost of such immunotherapy can reach up to ₱1 million for a single treatment cycle.

These prices do not account for the extensive recovery needed for these critical illnesses once you leave the hospital.

While your HMO can help manage medical expenses, it may not fully protect you against healthcare costs, which you may discover only after an accident or illness.

HMOs typically cover basic and routine healthcare needs such as annual checkups, laboratory tests, and minor procedures. But if you get diagnosed with critical illness, you can end up paying a sizeable amount out-of-pocket.

For example, the standard treatment for a stroke costs ₱1.8 million. You may need to pay 90% of the hospital bill after a PhilHealth deduction (around ₱76,000) and HMO coverage (typically ₱90,000 for employees).

These numbers do not include healthcare costs for rehabilitation after a stroke, which can take months or even years. You might be unable to work during this time, putting more pressure on your finances.

While you can supplement your HMO with your savings, this strategy only works if the annual growth of your money can keep up with the rapid increase in medical costs. And remember, you have to rebuild your savings ASAP to ensure you're prepared for anything.

To prepare for unexpected medical emergencies, whether a minor injury or a major critical illness, AIA has long offered a co-pay Medical Benefit Rider that covers up to 90% of inpatient hospitalization and medical expenses after PhilHealth deductions.

AIA has now upgraded this health coverage add-on and is introducing the Enhanced Medical Benefit Rider (eMBR) powered by MediCard. In addition to the existing 90% coverage, the eMBR provides additional protection against more medical and hospitalization costs. 

As you will see below, the benefits work like an HMO and immediately accessible during challenging times.

HMOs can cover up to ₱300,000 of healthcare costs. But eMBR's annual benefit limit can start at ₱750,000 up to ₱6 million. It can supplement your company’s HMO benefits, especially for costly inpatient hospitalization and treatments.

In addition to inpatient benefit, critical care and surgical benefits, eMBR provides emergency inpatient and outpatient care with ambulance services, a new feature in insurance add-ons.

eMBR provides coverage for medical consultations, diagnostic tests, and prescription medication related to the reason of confinement, 30 days before and after your hospital admission.

Many insurance plans only cover medical benefits up to 60 or 70 years old. AIA offers eMBR for individuals up to 75 years of age and can enjoy benefits until they reach 80.

eMBR includes annual physical exams, 24/7 teleconsultations, dental services, and mental health support.

A key advantage of eMBR is it can be seamlessly added to a new AIA life insurance plan. This integration provides a powerful and convenient solution for managing your healthcare costs while protecting your loved ones.

Imagine a scenario where you have an AIA life insurance plan paired with eMBR plus a Critical Illness Rider. Here's how the different components come together to help you get treatment and focus on recovery while maintaining your hard-earned savings:

• If you're hospitalized, eMBR can cover up to 90% of your inpatient hospitalization and medical expenses outside your HMO's limits. 
• An AIA life insurance with critical illness add-on provides a lump-sum payout that can help support you during recovery after hospitalization and/or critical illness. This benefit allows you to continue paying your bills and other obligations, even if you cannot work.
• Some AIA life insurance plans have an investment component, while others offer guaranteed cash payouts. Either option can become an additional source to grow a medical fund in case of unexpected illnesses. You can get the right life insurance product depending on your specific protection needs. 
• In the unfortunate event of your passing, your loved one or life insurance beneficiary will receive up to 200% of your life insurance coverage (depending on your chosen plan). It provides them with a financial buffer for burial expenses, cleanup funds, and other financial needs in the future.

Planning for healthcare costs requires a proactive approach beyond relying solely on savings and HMOs. With the right mix of life insurance with health and medical insurance riders, you can safeguard your finances while getting comprehensive health and medical protection. 

Take steps toward a healthier future by consulting with an AIA Life Planner! Learn more about the Enhanced Medical Benefit Rider and explore other AIA health protection solutions designed to prepare you for wherever life goes.