What Is Kaiser Long Term Health Care?

Kaiser Long Term Health is a Medical Insurance that aims to give you a financial support for your health when you get old.

Disclaimer: I am a member of IMG (International Marketing Group), accredited broker of Kaiser, and I earn for every policy that we can close. We consider Long Term Health Care as level 1 of Financial Freedom and Financial Peace.  You are suggested to ask question through this blog so that I can increase the Q&A Part of this post.

General Notes
1.)    Kaiser’s Long Term Plan Health Care program is focused on four key areas:

1. Healthcare Program
2. Healthcare Savings
3. Insurance Benefit
4. Emergency Fund

2.)    Non Phil health Member should pay the Phil health coverage payment before using Kaiser. So it is necessary to be a Phil health Member.

3.)    Lifetime Network access to over 500 hospitals and over 1,000 doctors as long as you have funds. ( Accredited Partners )

4.)    A total of Php 2,500 is required as Policy Fee but can be paid on a yearly basis of 500 per year.

5.)    Payment can be made on 5 options.

• Monthly
• Semi Annually
• Quarterly
• Annually
• Spot Cash

6.)    Kaiser Long Term Health Care is a combination of Health Insurance, Term life, Investment, Low Monthly cost, Cash Value Guaranteed, Death Benefit and More.

Updates : Low Monthly cost shall mean that monthly payment for policy is low compared to others..

Additional Info : Cash Value can only be guaranteed if the plan holder didn’t utilize the plan and returns in the extended period were all 10%, if the return/s within extended period dropped to 7%(minimum) the cash value will also be adjusted.

7.)    Plan will be lapsed for non-payments, 60 days after due date (grace period). With 2 years allowance for policy reinstatement due to plan lapsed.

More on grace period: Let’s say you’re paying monthly and your due is on May 10, your next due date is June 10. If you were not able to pay on June 10 it will lapse after July 10. From May 10 to July 10 that is what we mean by 60 days.

8.) The policy is for individual use only.However a family assistance is possible upon approval.Family assistance is not included in the contract.

9.)    Long Term Health Care is only applicable from 10 Years Old – up to 60 Years Old. Suggested Plans as follows:

1. Ages 10 – 40 is K45 as minimum
2. Ages 41 – 50 is K60 as minimum
3. Ages 51 –  60 is K75 as minimum

Accumulation Period

1.)    This is the time were you are paying your policy. It can also be referred as the paying period. It has a total of 7 years.

2.)    This is also the period were you are covered with a fixed amount of Annual benefit limit. As an example if you choose a K60 plan, it means that you have a 60,000 Annual benefit Limit, if you choose K100, then you could have a 100,000 annual benefit limit.

3.)    If the planholder dies w/in Accumulation Period, his/her principal beneficiary named in the contract shall be substituted as the new member but with no longer insurance benefit.

4.)    Pre Existing Illness- Planholder shall not be covered during accumulation period. However,  all pre-existing illnesses are covered during the extended period, long-term care period and extended benefit balance period which can be charged to the annual health benefits, total health benefits and annual lifetime healthcare benefits respectively. (Pre Existing Illness)

5.)    Members can enjoy the Medical and Dental Benefits with no effect to Your Long Term Health Care Bonus. (Medical and Health Benefits)

6.)    Should there be no claim made during this period, members will avail the Long Term Care Benefits at the end of 20th year.

7.)    Members is covered with Term Life Insurance during this period.

8.)    The room and board benefit is covered only during the Accumulation period. During the Extended period your room and board will be charged to your unused Yearly Health Benefits.

Extended Period

1.)    Extended period starts at the end of the 7^th year

2.)    This is when the 10% of your plan is given on a yearly basis as your benefit limit and is rolled over with an interest ranging from 7% (Minimum) to 10% (Maximum). As an example if you have K50, therefore 10% of 50,000 is 5,000. The policy holder will be given a 5,000 Annual Benefit limit which could be claim thru reimbursement.

3.)    Unused yearly health benefits is being accumulated if it is not used.

4.)    If the planholder dies w/in Extended Period, the contract shall be considered terminated and his/her beneficiary named in the contract shall be entitled to the corresponding cash value.

5.)    Members is covered with Term Life Insurance during this period.

Long Term Care Period

1.)    Members will be given a Visa Card that he can use for anyone, anywhere and anything.

2.)    Long Term care period starts at the end of 20^th Year

3.)    Long Term Care bonus maybe acquired if there is no claim maid during the accumulation period. The total amount can be withdrawn or added

4.)    Members enjoy his investments during the Accumulation period.

My Take:

1.)    This is really good for OFW specially to those OFW in countries where medical benefits is covered. The payment to be paid will serve as an investment in preparation for the future, especially when we get old.

2.)    OFW will normally not be able to use this in the accumulation period since they are abroad. But what happen when the OFW is now 65 years or retiring age? Then this will help them to cope up with the high cost health care.

FREQUENTLY ASKED QUESTIONS

Q: Is Kaiser a Scam?
A. Kaiser is definitely not a scam and therefore regulated by the government.
Quoting Kaiser Website :
“The Healthcare Industry is a highly regulated industry. Before any company can be licensed it has to fully comply with all the government requirements to make sure it is fully secured and can deliver its benefits to its clients. It is regularly monitored by the regulatory government agencies. Our Kaiser Health plans are designed by a Licensed Actuary not only to ensure compliance with established government regulations but also to make sure that our products are financially sound and stable. Kaiser is one of the top most healthcare company in the Healthcare Industry in terms of capitalization and market share. Kaiser is fully compliant with the regulatory requirements. On top of this, Kaiser’s cornerstone of success resides in the skill and experience of its corporate management, and its business partners. Kaiser draws great strength from a leadership team which thoroughly understands the company industry and operating environment. It possesses close, long-term relationships with its members and partners throughout the country. With Kaiser’s strong financial stability, our clients are highly secured.• Kaiser deals with top notch and highly qualified licensed financial managers. We consider them as partners and work very closely with them. The managers themselves are also governed by government regulations. In addition, we deal with some of the country’s best universal banks.”

Frequently asked question from their website:

Frequently Asked Questions from Kaiser Website

Question No. 1

It’s the first time I’ve heard about Kaiser. What is it?

Answer:
Kaiser International Healthgroup Inc. is accredited by the department of Health as an HMO. It is registered with the Securities and Exchange Commission as a health care provider and broker for other health care companies.

Question No. 2

Who are the persons behind Kaiser?

Answer:
Kaiser’s Board of Directors is seasoned experts in the Medical field services and the health care Industry. Headed by its President and CEO Dr. Ramon B. Abragan, Jr..

Question No. 3

What is the financial viability of Kaiser?

Answer:
Kaiser is registered with SEC and has an authorized capitalization of Php 160M. It has fully complied with all the SEC regulations. It is also approved by Department of Health to operate as an HMO. The Investment and funds are managed by the top leading financial Institutions in the Industry.

Question No. 4

I have just bought a Kaiser 35,000 plan and would want to have a bigger coverage. Can I upgrade or buy another plan?

Answer:
Yes, a plan holder or member may upgrade his plan within 30 days from the member’s effectivity date. The member may buy another plan only upon full payment of his policy which is on the 6th year.

Question No. 5

I have just bought a Kaiser-100,000 plan. Can I now avail of the Annual Physical and Dental Examination?

Answer:
The member can avail of these two outpatient benefits after paying fully paying the first year’s premium. E.g. If his mode of payment is annual, then he can avail immediately after receiving his member’s kit containing his ID, benefit and dental card, provider directory, guide book and your schedule of benefits with the contract provisions.

Question No. 6

I have a Kaiser-55,000 plan which I’d like to transfer to my daughter coz I’m migrating to the U.SA. How do I go about transferring it?

Answer:
The member shall be required to sign an amendment form and the daughter signs a new application for membership form and submit it to his IMG representative/offices or to Kaiser office located respectively at the 3rd and ground floor of King’s Court I Building along 2129 Chino Roces Avenue in Makati City.

Question No. 7

Do I need to use Kaiser’s network of providers?

Answer:
Yes. You must stay within the network at least during the accumulation or Paying Period. However, on the 6th year onwards, you can avail of your medical needs using your own set of providers and then file for reimbursement within your allowable health benefit.

Question No. 8

If a member dies, is his K100, 000 plan transferable to any of his beneficiaries? How much will his beneficiary get?

Answer:
If the plan has approved term insurance coverage, the plan is transferable to the primary beneficiary. Kaiser shall pay the principal amount of the term insurance equivalent to the member’s long-term care benefit Php 100,000. If the cause of death is an accident, another Php 100,000 shall be paid.

Question No. 9
Why should I buy a Kaiser health care plan when my family and I are now covered by my husband’s employer healthcare plan?

Answer:
Your family coverage with the employer’s healthcare plan is given to your husband as part of his employee benefit and continues to be available as your husband is employed with the company. However, by the time your husband resigns or retires from the company, this companies healthcare plan benefit stops!

Q: How sure am I that I can get the benefits during the years as promised?

Answer:
There is no such thing as RISK FREE investment, we take risk in order for us to gain. I cannot promise that the company will still be there after we became old, but one thing is for sure. I am also a member of Kaiser and I believe that the company can fulfill in his promise. And if I will not get this kind of investment, I am sure that I will have problem when I get old. So better take the risk of paying for my long term health care than a sure looser when I get old. It is up to you to decide.

Kaiser is one of my diversified investment.

Q: When and how can I apply for a “rider”?

Answer:
Rider can be purchased only within two (2) years upon the effectively of your plan. KAISER have a separate application form for this and could also be paid in SPOT CASH or within FIVE YEAR PERIOD.

Q: Can my family get a hospitalization discount using my membership?

Answer:
Please note that each plan is solely for the use of the planholder, therefore availment of the benefits cannot be used by your beneficiaries. However, Kaiser have an added service which they call Family Assistance Service where your family member within the 1st degree of consanguinity can use your membership and avail of the rates which is being accorded to us by our hospital providers.

Please note that this service does not form part of the contract. This is an added service only hence, approval &/or denial of the use of this service lies solely on Kaiser’s discretion.

Family Assistance Service
Requirements

1. Policy should be in ACTIVE status and plan should have completed at least one (1) year of payment. Planholder to seek Kaiser Approval for its availment.

2. Nominated patient must be an immediate family member of the Policy holder or within the 1st degree of consanguinity.

3. Policy holder should agree to avail only of the services of Kaiser’s accredited Doctors and affiliated network of hospitals.

4. Assistance to be provided by Kaiser shall only be to the extent of the allowable benefits due to the planholder under his policy.

5. Prior to discharge of the nominated patient, payment should have been settled with Kaiser.

6. If Planholder requested or opted to pay on a “term basis” – Payment Scheme is on a case to case basis and subject to Kaiser approval.

Q. What if I migrated to other country such as Canada? Can I still use my Kaiser?

Answer:
Once the plan matures, you will be given with a VISA Card, where you being given a credit line equivalent to your Long Term Health Care Benefits. Technically you CAN USE IT FOR ANYONE, ANYWHERE AND ANYTHING

Q. Can I take the Value of Long Term Health Care after 30 years? If there will still be funds in my account?

Answer:
YES

Q. If the members died after 30 years upon payment then there ar still funds in the Long term health care, can the beneficiary get the accumulated amount?

Answer:
Yes

Q. Where can we get the ID and the Policy?

Answer:
There are different offices all over the world. Since we are in KSA, whenever there are members that joins through us, we will facilitate the delivery of the policy in KSA. For other countries please contact us.

Useful Website:
Pinoy Investment Guide Blog – http://www.pinoyinvestmentguide.com/
IMG Website – http://img-corp.com/
Kaiser Website – http://www.kaiserhealthgroup.com/

Should You Have Any Question, Please Contact US and we would be happy to respond. You may also use the comment section below. You may also use the form below to ask for quotations Be sure to Confirm your subscription.

Notes : Thanks to Sir Rex Holgado & Fely Santiago for some inputs