| Welcome
to Health Maintenance, Inc. |
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Frequently
Asked Questions (FAQs)
HMI
(Health Maintenance, Inc.) is THE Pioneer
HMO (Health Maintenance Organization) in
the Philippines, incorporated on May 4,
1981. We sell prepaid healthcare memberships
to individuals, families, groups and corporations,
on a Monthly, Quarterly, Semi-Annual, or
Annual mode of payment. Members can avail
of medical services here and now regardless
of how many times these services are availed
of. |
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Applicants
who are at least three (3) months old and
not more than fifty-nine (59) years of age
can apply for an HMI membership. 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. |
| If
you are an HMI member in good standing,
you will benefit from medical services without
having to shell-out cash as long as the
services needed are within the scope and
limits of the service agreement: |
A.
Any number of consultations with our doctors/partners
at your accredited hospital and
at the three (3) HMI Clinics (Out-Patient
care)
B. Laboratory and Diagnostic procedures
C. Hospitalization (In-Patient care)
D. Emergency care;
E. Dental care (if you have availed of
the dental option)
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| Yes,
you can avail of the medical services upon
receipt of your HMI Membership Card within
the effective period by simply presenting
your valid HMI Card to your HMI Physician-In-Charge
at your accredited hospital or at the HMI
Clinics located in Makati Cinema Square’s
first basement, Room 201 MATI Building at
the New Medical City Hospital and Room1105
Cathedral Heights, St. Luke’s Compound. |
No.
The evidence of your membership is your
HMI Membership Card and it is the key to
the medical services offered by HMI. Verification
of the HMI Membership Card presented to
our medical providers is our way of checking
that you are the only person who makes use
of your benefit limits. Thus a “NO
CARD, NO SERVICE” policy is being
implemented for your own protection. |
A. |
Your
membership fee should be paid on or before due date |
B. |
Your
HMI membership card should be VALID/ACTIVE |
C. |
You
should avail medical services through HMI
accredited doctor |
D. |
You
should avail medical services at your HMI
accredited hospital or |
E. |
MSU
(Medical Service Unit) printed on your HMI
Membership Card |
It
is an illness/medical condition or injury
which you already had prior to enrolling
with HMI, or considered to have been in existence
within the first twelve (12) months of membership. |
A
pre-existing medical condition may only
be covered by HMI after twelve (12) consecutive
months of membership without interruption,
provided that such condition is properly
disclosed on the HMI application form, that
no waiver of medical benefits was issued,
and that the member renews his membership
for another term in the immediately succeeding
year without interruption. |
An
HMI Physician-In-Charge is a consultant
who heads our group of doctors, known as
the HMI Medical Service Unit (MSU), at our
accredited hospitals. As such, the PIC initially
sees you, directs your treatment, and manages
your condition. If there is a need to refer
you to other team members who are specialists,
then the PIC does this for you. This set
up is important because it saves you the
trouble of looking for other doctors to
go to, if necessary, and someone, like your
PIC, is on top managing your condition.
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HMI
PICs/Doctors usually have Doctor Relievers
when they take a leave of absence. If
this happens, you may be referred to another
HMI accredited doctor by our HMI Hospital
Operations staff at the Main office, Please
call 812-8806 up to 08.
Also,
if you are within the area where our 3
clinics are located and would need medical
attention, please visit us at:
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| A. |
Makati Cinema Square’s First Basement,
Chino Roces Avenue, Makati City |
| B.
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Room
1105-1106 Cathedral Heights Building, SLMC
Coumpound,
Quezon Avenue, Q.C. |
| C.
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Room
201, MATI, The New Medical City Hospital,
Meralco Compound, Ortigas Center, Pasig City. |
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This facility primary health care delivery center - It is a multi-specialty clinic that can provide the following: |
A. |
Automated laboratory (newly acquired Abbott
Chemistry Analyzer) |
B. |
X-ray |
C. |
Ultrasound |
D. |
ECG |
E. |
Treadmill
test (newly acquired treadmill machine) |
F. |
Minor
out-patient surgery that does not require
overnight stay |
G. |
Out-patient
diagnostic and therapeutic procedures in GI
Endoscopy |
H. |
Packaged
Pre-Employment |
I. |
Packages
Annual Physical Examination |
J. |
Out-patient
Executive check-up |
SPECIALISTS |
A. |
Internal/Family
Medicine |
B. |
Pediatric |
C. |
Cardiology |
D. |
Dermatology
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E. |
EENT |
F. |
Gastroenterology |
G. |
Nephrology |
H. |
OB-Gynecology
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I. |
Orthopedics |
J. |
Pulmonary |
K. |
Rheumatology |
L. |
Urology |
The
above-mentioned services can be availed
of even by non-HMI members |
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
and our staff will be happy to refer you
to the nearest laboratory or diagnostic
center or hospital convenient to you. |
HMI
will not cover outright any vehicular accident
hospitalization expenses. However, the amount
you paid to the hospital during your hospitalization
period will be reimbursed by HMI,
if it has been 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. |
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. However, valid medical expenses
filed within 30 days may be paid by HMI
by way of reimbursement, if the documents
submitted are complete and it is proven
that the case was an EMERGENCY (a life and
death situation). You will be paid eighty
percent (80%) of the total reimbursable
amount but not to exceed the allowed maximum
amount under the HMI member’s enrolled
program. |
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Health
Maintenance Inc. Copyright © 2006. All rights reserved.
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