Kaiser is often described as a 3-in-1 product, because it provides life insurance, gives long-term healthcare benefits, and acts as an investment fund.
When you avail of a Kaiser plan, you will go through three main periods. The first one is the Accumulation Period, then the Extended Period, and lastly, the Start of Long-Term Care Period.
ACCUMULATION PERIOD (Year 1 to Year 7)
You will only need to pay for your Kaiser plan for seven years. You can choose to pay monthly, quarterly, semi-annually, annually, or even spot-cash.
Again, this is called the Accumulation Period because it’s the only time you will be paying for your policy. After Year 7, you will no longer need to pay for anything.
During the Accumulation Period, you will have the following benefits:
- FREE Annual Physical Exam (APE)
- FREE Dental benefits
- Waiver of installment upon death or disability
- Basic Medical benefits (similar to having an HMO health insurance)
- Member’s choice of room and board (depends on the plan)
- Annual Benefit Limit (at least P50,000 per year, depends on the plan)
- Term Life Insurance (amount benefit depends on the plan)
- Accidental Death and Dismemberment benefits
- Lifetime network access to over 500 hospitals and 1,000 doctors (as long as you have funds)
EXTENDED PERIOD (Year 8 to Year 20)
Once you’ve finished paying for your Kaiser policy, starting at Year 8 until Year 20, all you need to do is to wait for the plan’s maturity or for this Extended Period to end.
Again, there’s no need to pay for anything during this time. You just sit back and enjoy ALL the benefits you have during the Accumulation Period. Except of course, the waiver of installment; because at this point, you have already finished paying.
The main difference between this period and the previous one is that the costs of your healthcare will now be deducted from your annual health benefits, the amount of which depends on your plan.
However, at the end of each year, whatever amount that is left unused in your healthcare fund will now earn interest and accumulate. That’s because your fund is actually invested, and this is when Kaiser becomes an investment fund. Your Kaiser fund can earn a return of 10% per year. It can be lower or higher, depending on how the market is doing.
START OF LONG-TERM CARE PERIOD (Year 21 onwards)
At the end of the Extended Period (Year 20), or upon maturity of your plan, you will receive the following:
- Total amount of accumulated unused health benefits
- Long-term care benefit or the plan coverage that you got
- Long-term care bonus, which can be up to 85% of premium contributed, if you did not have a confinement claim during the first 7 years
- Additional health benefits if the market is at top performance
And the plan holder now has the option to withdraw all the money, or take half and let the balance earn more inside the fund and receive it on installment similar to a pension-type of allowance.
For example, if you bought the K-100 plan (P100,000 long-term care benefit). You will pay P58,821.43 per year for seven years, for a total contract price of P411,750.
Assuming no claims were done up to Year 20, and you opted to withdraw all the money, then all the cash benefits you’ll receive could total up to P1,166,169 (more than P1.1 million estimate).
This product is a health fund for when you get sick; but if you remain healthy, then it becomes a savings and investment fund.
Unlike traditional healthcare (short-term health insurance provided by HMOs), which you pay and no premium is returned to you if not used, Kaiser provides the opportunity to grow your money as reward for being healthy.
Moreover, Kaiser long-term healthcare can cover you even beyond the age of 60, when most health insurance companies will no longer accept you.
It’s also essential to mention that a person’s Philhealth benefits are integrated in Kaiser. If you’re hospitalized, for example, both Philhealth and Kaiser can cumulatively cover your hospital bills.