What is HMI?
Health Maintenance, Inc., or HMI, is THE Pioneer Health Maintenance Organization (HMO) in the Philippines, incorporated on May 4, 1981. We sell prepaid healthcare memberships to corporations, groups, families, and individuals, on an Annual, Semi-annual, Quarterly, or Monthly mode of payment. HMI members can avail of medical services here and now using our vast network of accredited medical providers and partners.
Who are eligible to become HMI Members?
Applicants who are at least three (3) months old and not more than fifty-nine (59) years old. However, an applicant of minor age (3 months to 17 years old) must enroll together with a principal of legal age, like parent/s or guardian/s.
What are the HMI healthcare/medical benefits?
An HMI member in good standing will get free healthcare/medical benefits based on the limits of his enrolled healthcare plan or program type, such as:
- Out-Patient care: Any number of consultations with the HMI PIC/doctors at your designated HMI accredited hospital or the three (3) HMI Clinics
- Laboratory Tests and Diagnostic procedures
- In-Patient Care: Hospitalization/Confinement
- Emergency care
- Dental care: for members enrolled with dental benefits
To know more about HMI healthcare/medical services, please click: www.hmi.com.ph
Can I avail of the medical benefits at once upon receipt of my HMI Card?
You can start availing of the medical benefits on the first day of your effective date and if your HMI Membership fee is paid on time.
How will I maintain the “active” status of my HMI membership?
- Pay your membership fee on or before due date,
- Ensure that your HMI Card is renewed and is valid and effective,
- Pay all other outstanding arrears and receivables.
Can I avail of the HMI Medical Benefits if my HMI Card is expired?
Sorry, but you cannot avail of the medical benefits if you have an expired HMI Card. Your valid HMI Card is the key for you to avail of your medical benefits, so always make it a point to renew your HMI Card. Your HMI Card is also used to verify the status of your membership and your identity as an HMI Member.
Please remember: Always present your HMI Card. No Card, No Service.
Where can I avail of my healthcare/medical benefits?
At any of the following HMI Clinics in these areas:
Makati Square's First Basement
Don Chino Roces Avenue,
Telephone Numbers: 811-1772 / 844-8151 / 842-6215 / 811-1313 or 752-0552
- QUEZON CITY:
Rooms 1105-1106 Cathedral Heights Building
St. Luke's Compound, E. Rodriguez Avenue
Telephone Numbers: 721-4475 / 723-0101 Locals 2105 & 2106.
Room 201, MATI, The New Medical City Hospital
Meralco Compound, Ortigas Avenue
Telephone Numbers: 687-4773 / 637-4426 / 635-6789 Local 3001
Or at your HMI Accredited Doctor during his clinic hours at your designed / chosen hospital.What are the medical services at the HMI Clinic-Makati?
You can avail of any of the following medical services:
- A. Laboratory Tests
- B. X-ray
- C. Ultrasound
- D. ECG
- E. Treadmill Test
- F. Minor out-patient surgery (does not require overnight stay)
- G. Out-patient diagnostic and therapeutic procedures in GI Endoscopy
- H. Pre-Employment Packages
- I. Annual Physical Examination Packages
- J. Out-patient Executive check-up
Specialists available at HMI Clinic-Makati:
- A. Internal/Family Medicine
- B. Pediatric
- C. Cardiology
- D. Dermatology
- E. EENT
- F. Gastroenterology
- G. Nephrology
- H. OB-Gynecology
- I. Orthopedics
- J. Pulmonary
- K. Rheumatology
- L. Urology
The above-mentioned services are also open and available to non-HMI members.
Why should I pass through the HMI Physician-in-Charge (PIC) every time I need a consultation?
An HMI PIC is the Head of the HMI Group of Doctors/Specialists in the HMI Accredited Hospital. The HMI-PIC initially sees you, directs your treatment, and manages your condition. If there is a need to refer you to other team members and/or specialists, then the PIC does this for you. He will choose your Specialist (also HMI accredited) and will give you the referral form needed.
What shall i do if the HMI PIC/Doctor is not available?
HMI PICs/Doctors usually have reliever/s if they are on official leave. You may also proceed to any of our HMI Clinics in Makati, Quezon City, or Pasig areas (please see addresses and phone numbers mentioned above). Or, you may call our Hospital Operations Department in HMI Makati office at 752-0552 and at 811-1313, they will be glad to assist you and may refer you to another HMI accredited physician.
What if the test(s) requested by the PIC or an accredited doctor is not available in my designated accredited hospital, what shall I do?
This should not happen because before you are given a referral by our medical provider/s, we make sure that all tests shall be done in one place for your convenience.
In case of this unfortunate situation, please call our HMI Main Office at 811-1313 or 752-0552 and our staff will be happy to refer you to the nearest laboratory or diagnostic center or hospital convenient to you.
I get hospitalized due to an accident, will you pay for my hospital expenses?
HMI will not cover outright any vehicular accident hospitalization expenses. However, the amount you paid to the hospital during your hospitalization will be reimbursed by HMI, if it is proven that the vehicular accident is NOT due to your own fault or negligence, and that all required documents are submitted to HMI within 30-days from the date of the accident. Reimbursement is subject to limits stated in your Service Agreement/Contract.
Do you cover emergency cases in non-HMI accredited hospitals?
If the hospital is not accredited with HMI and there is no mutual understanding between the two entities, we cannot issue a letter of authorization to cover the medical expenses incurred during the confinement or the availment at the Emergency Room of the non-accredited hospital. Medical expenses must be filed for reimbursement with HMI and will be subject to approval and may be paid according to the limits of your plan or program type. HMI reserves the right to validate that any HMI accredited hospital was not used because to have done so would entail delay which could possibly result in death, serious disability, or significant jeopardy to the member's condition.
During my confinement, who is responsible for filing my Philhealth form with the hospital? What will happen if I fail to file it?
You are the one responsible for filing your Philhealth Form. In case you fail to file it during confinement, you will have to pay the amount corresponding to the Philhealth benefit and you may apply for reimbursement with Philhealth.
You may secure the following from your company's HR representative:
- Signed Philhealth Claim Form 1
- Philhealth Contributions & Members Data Record (MDR)
- Philhealth Claim Form 2. The Philhealth Claim Form 2 should signed by your attending physician before hospital discharge.
The HMI In-Patient Coordinator will remind you to submit the said forms. Please be reminded they are not responsible for the actual filing of said forms.
For non-Philhealth members, the member should pay the Philhealth portion billed by the hospital prior to discharge.
Why do I need to pay for the professional fees of Neurologists?
At the moment the professional fees of Neurologists are on a "cash basis" policy for all HMO members, not just HMI members. This is due to the guidelines set by the Philippine Neurologist Society.
After paying for the cost of the professional fees, you may file for reimbursement at the Claims Department at the HMI office. Reimbursement will be based on HMI's Relative Value Scale (RVS).
For the procedures performed, HMI will cover the member's availment according to his/her HMI plan?
If there is no available room under my program type during the time of my admission, what do you advice me to do?
- If you do not want to pay additional room and board costs or charges, get a room rate lower than your enrolled program
- If you get a room rate higher than your enrolled program, you will be charged for room and board excess plus incremental charges. Ask the hospital's Admissions Department to transfer you to your enrolled room category as soon as possible.
- You may ask HMI Hospital Operations Department staff for a transfer to another HMI accredited hospital, if your condition permits.
What will I do if there is no HMI accredited hospital in the area, and my condition is life threatening?
Go to the nearest hospital, and pay for your expenses. You may file for a reimbursement. Submit all requirements within 30 days after discharge to HMI Reimbursement Section.
If I choose to be admitted under the service of my own doctor, will HMI cover my confinement?
HMI will not cover your confinement. Under our service agreement you must be admitted under the care of the HMI PIC for HMI benefits to be extended to you.
Is vaccination and immunization covered?
HMI shall cover consultation and administration but not the cost of the vaccines.
What is a Pre-Existing medical condition?
It is an illness/medical condition or injury which you already have prior to enrolling with HMI, or considered to have been in existence within the first twelve (12) months of membership.
When is a Pre-Existing medical condition covered?
It can only be covered after twelve (12) consecutive months of continuous membership, provided that:
- Such condition is properly disclosed on the HMI application form
- No waiver on medical condition was issued
- The member renews his membership for another term in the immediately succeeding year without interruption.
If I enroll just myself, will the rest of my family members benefit from it?
Unfortunately NO, The membership fee is for one person only and is not transferable.
What should I do if I my HMI card gets lost?
- A lost HMI Card must be reported to HMI office immediately at 844-6715/811-1313.
- Fill-up an HMI Affidavit of Lost Card Form (can be downloaded from our website).
- Pay processing Fee at the Cashiering Section.
- Submit the accomplished "Affidavit of Lost Card" form to the Membership Processing Department, and a new HMI Card will be issued to you.