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1. How do I know if a certain diagnostic procedure requested by an affiliated doctor is covered by my healthcare program?

For inquiries on your benefit coverage, you may call any of our Customer Care hotlines. Your medical details and needed procedure/s will be assessed if coverable (or otherwise) by your plan.

2. How do I avail of my Annual Check – Up (ACU) benefit?

A request for an ACU schedule will be needed prior to actual availment. This can be done thru the following:

  • For ACU contact number 9086900 Loc. 1229, 1230, 1304.
  • For ECU 9086900 Loc. 1204, 1308
  • Mobile number : 09988430631/09178147314
  • Email Address: acu-team.medical@maxicare.com.ph
  • Member can call to those numbers Monday – Sunday 8:00-5:00PM
3. What happens if I fail to file our PhilHealth Benefit Claim form upon discharge?

You will have to shoulder the PhilHealth cost equivalent upon discharge.

4. What do I have to do to reimburse my bills from availments in non – affiliated hospitals during Emergency cases?

You will need to submit the following necessary documents:

o Duly accomplished Claims Reimbursement Form
o Original Official Receipt/s of the hospital bill/s, including the Statement of Account (SOA) and its Charge Slips
o Clinical Abstract of the case, if surgical intervention was performed and its hispathological report
o Operative Record of the case/treatment or admission/discharge record duly signed by the attending Physician.

5. When do I get my check (reimbursement) after submitting all the necessary requirements?

Reimbursement/s released via check will be available within 30 working days upon the receipt of complete and valid requirements at the Maxicare Head Office.

6. Is it true that EENT Specialists, Neurologists and Urologists have issued a memorandum to all HMOs stating that they will charge additional Professional Fees?

Yes. However, for you to avoid this extra charging, kindly coordinate with our Customer Care Department before each availment for them to be able to make arrangements with a doctor who does not charge extra fees.

7. What if I want to upgrade my Room and Board entitlement during elective confinement?

It is possible and we are not refraining you to upgrade your Room and Board Accommodation as you wish, provided that you will have to shoulder the corresponding Room and Board excess fees, incremental costs of laboratory and procedures done, and the excess Professional Fees.

8. What do I have to do if I lost my Maxicare Multifunction Card?
  • You must prepare the following requirements and submit them to the Maxicare Head Office:

1) Valid proof of payment (Php 200.00 Lost ID Card fee) 

For payment, you may pay over-the-counter through bills payment at the following banks: BDO, Equicom Savings Bank, Philippine National Bank, Security Bank, BPI, Metrobank, RCBC, Union Bank, Maybank, AUB

2) Maxicare’s Statement of Lost ID Card 

3) Photocopy of the front and back portion of a valid ID with picture or notarized affidavit of loss 

 

Your new Maxicare Multifunction Card will be issued within seven (7) working days from the date the necessary documents were forwarded to us.

 

  • Should you need to avail of any medical services while your card has not arrived yet, please call any of our Customer Care Hotline Numbers first prior to availment. For Emergency Cases, on the other hand, please instruct your Companion (if available) to call Maxicare.
9. Are your Hotline Numbers available even at midnight?

Our Customer Care operates 24/7 and is manned by Specialists / Representatives highly trained to assist you in any of your needed medical availments.

10. Are you open on weekends?

Our Primary Care Centers and Helpdesks are open from Monday to Saturday.

You may also visit any of our MyHealth Clinics for your Letter of Authorization (LOA) request or Out – Patient medical services. They are open Monday – Sunday, 7:00 A.M. – 8:00 P.M.

1. What is a Customer Information Form?

A Customer Information Form, or CIF, requires Members to provide important, personal information that will allow Maxicare to assume accurate information and be able to provide better and more efficient services to you.

This document is, also, in compliance to the “Know Your Customer” (KYC) policy which necessitates the identity validation of a customer availing of certain financial transactions. In our case, the Maxicare Multifunction Card acts as a Cash Card in occasions of claims reimbursement.

Completion of the CIF is a one – time requirement only; however, updating should be done should there be significant changes in the personal information of the Member such as Home Address, Contact Number, Marital Status et al.

2. How is this related to my Maxicare Multifunction Card?

The Maxicare Multifunction Card can be a Cash Card. Should you have any Claims Reimbursement, this is where your reimbursement will be credited. Powered by Equicom Savings Bank, this financial transaction shall, therefore, need you to comply with the KYC policy requirement.
Beginning February 1, 2015, reimbursements and other cash – related transactions, through your Maxicare Multifunction Card, will not be possible and accommodated without completing the CIF.

3. What is the purpose of the CIF given that the membership details are provided by the HR?

The details provided by the HR of our member companies do not include all the information required to comply with the KYC. Furthermore, since the cash crediting is considered as a personal transaction, the Members must, individually, provide his personal information and must agree on the Terms and Conditions covering the Maxicare Multifunction Card.

4. What will be the downside if Member does not accomplish the CIF?

If your Maxicare Multifunction Card is enrolled in the Cash Card functionality, a Member’s reimbursement will not be processed timely as an accomplished CIF is one of the requirements in full compliance of the claims reimbursement process.

5. If the CIF has been submitted during the initial reimbursement, do I need to submit on the succeeding filings?

No. CIF submission is a one – time requirement only. This is, unless, there are changes in the Member’s personal information hence the need for updating of the CIF.

6. How can I accomplish the CIF?

You may accomplish the CIF online via the Member Gateway and follow the instructions provided in the portal.

7. What IDs are considered valid?

The following are considered valid by Maxicare:

• Alien Certificate of Registration (for foreign nationals in the Philippines)
• Company ID
• Driver’s License
• GOCC ID
• Government System Insurance Service (GSIS) e-Card
• Integrated Bar of the Philippines ID
• National Bureau of Investigation (NBI) Clearance
• Overseas Filipino Worker ID
• Overseas Workers Welfare Administration (OWWA) ID
• Passport
• Police Clearance
• Postal ID
• Philippine Regulatory Commission (PRC) ID
• Seaman’s Book
• Senior Citizen ID
• Social Security System (SSS) ID
• Student’s ID
• Unified Multi – Purpose ID
• Voter’s ID

*Please note that the IDs should not be expired by the time of CIF completion to be considered valid.

8. How will I know if my CIF has been processed or otherwise?

A notification will be sent by Maxicare to the Member once the original, hard copy of the CIF has been submitted to Maxicare.

Products and Benefits
1. How can I use my Maxicare Card?

For your medical availment, simply present your Maxicare card and a supporting ID to our Coordinator in any of our accredited facilities or to our Customer Care Representatives in our Primary Care Centers. Acceptable supporting identification cards can be any of the following: company ID or any government-issued ID or school ID, all bearing your signature and photo.
Upon presentation of your Maxicare card, our Customer Care Representatives or Coordinator will swipe your card for eligibility screening.

For out-patient consultations, our Maxicare Coordinator, who is a medical practitioner, will conduct his/her medical assessment and will prescribe the necessary treatment for your medical condition.

For elective or non-emergency confinement, please secure an admitting order from your accredited admitting physician and present this together with your Maxicare card and a valid ID to the hospital’s admitting section.

For an emergency availment, you may proceed to the nearest accredited hospital to your place of residence. Simply present your Maxicare card and a valid ID to the receiving desk of the hospital’s emergency section. If there are no Maxicare-accredited facilities near your place, you may still proceed to the nearest hospital or clinic. However, your medical availment will be handled on reimbursement basis subject to your program’s reimbursement provisions.

2. What are the benefits I can get from my Maxicare card?

Your Maxicare Card serves as your access to Maxicare’s excellent medical treatment provided by our top-caliber medical specialists from the country’s finest hospitals and clinics. This is made available to you on a non-cash basis.

Under your Maxicare healthcare program, you are entitled to out-patient consultations and hospital confinement benefits under the services of our accredited doctors. Emergency care, annual check-up and preventive care benefits are also included in your program. Application of these medical benefits will be based on your Maximum Benefit Limit (MBL) or Annual Benefit Limit (ABL) subject to your program’s exclusion and limitation provisions.

3. What is MyMaxicare Lite?

It is a prepaid health card of Maxicare which provides one – time In – Patient Care availment, of up to Php 25 000.00, exclusively covering eight (8) identified diseases.

The eight (8) identified diseases covered by MyMaxicare Lite are:
1.) Chikungunya
2.) Cholera
3.) Dengue
4.) Gastroenteritis
5.) Leptospirosis
6.) Malaria
7.) Pneumonia
8.) Typhoid and Paratyphoid.

4. What is an In – Patient Care?

It is commonly termed as Confinement, or a stay in a hospital facility for at least six (6) hours.

5. What are the benefits of MyMaxicare Lite?

MyMaxicare Lite provides the following benefits:

– Full confinement benefits such as Room and Board accommodation; use of Operating and Recovery rooms; use of Intensive Care Unit (ICU); Professional Fees of the attending Physician/s; standard Nursing services and admission kit; drugs and medicines for use in the hospital; whole blood / human blood products and IV fluids transfusion; X-Ray procedure, laboratory and diagnostics tests; Anesthesia; Oxygen and its administration; dressing, casts and other supplies or services directly related to the medical management of the patient.

– In – Patient Care coverage for one – time availment of up to Php 25 000.00.

– Nationwide access to Maxicare – affiliated hospital providers.

– 20% discount on basic dental procedures at any Metro Dental clinics and 15% discount on dermatology procedures at any MyHealth Clinics.

6. Who can avail of this prepaid health card?

This is available for purchase and usage to both Maxicare members and non – members aged two (2) years to 60 years old.

7. How much does MyMaxicare Lite costs?

MyMaxicare Lite is available in two (2) plans. While both plans have the same Maximum Benefit Limit of Php 25 000.00, the higher variant provides added comfort of having access to the major hospitals in Metro Manila.

Plan Type: Green
Cost (one-time payment only): Php 1,599.00
Access: Access to all Maxicare – affiliated hospitals nationwide, excluding the major* hospitals

Plan Type: Blue
Cost (one-time payment only): Php 2,199.00
Access: Access to all Maxicare – affiliated hospitals nationwide, including the major* hospitals

*Six (6) identified, major hospitals: Asian Hospital & Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center – Quezon City, St. Luke’s Medical Center – Taguig, The Medical City.

8. Where can I buy MyMaxicare Lite?
  • -You can buy MyMaxicare Lite at any Robinsons Department Store – Business Centers nationwide
  • – It is available through our Maxicare Account Officers. You may email Mishell Dalisay at mishell.dalisay@maxicare.com.ph.

    – You may also avail through our accredited Agents and Brokers nationwide.

    – We also have the following selling channels:
    o Maria Health

    • o IRemit
9. How do I use my MyMaxicare Lite?

Definitely, there is no need for paperworks. Registration is via SMS only. Just follow these steps below:

1.) Lightly scratch – off the gray panel found at the bottom of the signature panel to reveal the Medilink Number (starts with 1168).

2.) Register via SMS following this format: MAXIPREPAID<1168 Card Number>#<First Name>#<Middle Initial>#<Last Name>#<Birthdate in MMDDYYYY format>#<Civil Status>.

3.) Send it to any of the following numbers: 0917.8989691 / 0917.7776565 / 0999.8886565.

4.) You will receive a notification of successful Membership Enrollment
Once successfully registered, your MyMaxicare Lite membership will be activated 15 days from the time of registration.

Your card will be valid for one (1) year from the date of registration.

When confinement need arises due to any of the eight (8) identified diseases, present your MyMaxicare Lite together with a valid I.D. at any of our Maxicare – affiliated hospitals.

10. Can I have a Room and Board upgrade during the course of the confinement?

Yes you can; however, the cost difference between your preferred room and the standard room inclusion, plus the incremental rates due to the voluntary upgrading, will be charged at your expense.

11. If I want to transfer to another affiliated hospital provider, would I still be able to avail of the benefits of MyMaxicare Lite?

Once the card has been swiped in the hospital’s Maxicare POS and a Letter of Authorization (LOA) has been generated already, the MyMaxicare Lite card is considered used. This means, the card will be deactivated and no longer valid to be used in other providers, even if reason/s of transfer is/are due to unavailability of room and/or Physician/Specialist.

12. If after being discharged there are still necessary tests to be done that are not available in the affiliated hospital where I was confined, can I reimburse the costs to be incurred of the said procedures?

Unfortunately, no. MyMaxicare Lite only covers In – Patient Care availment; therefore, consultations and/or laboratory tests following the confinement are no longer covered. However, if during confinement there is a specimen that needs to be examined in other affiliated hospital, Maxicare will cover the cost, subject to the limit of your MyMaxicare Lite card coverage.

13. Can I reimburse my hospital bills and professional fees in a non – affiliated hospital?

No, it is not allowed.

14. If I have Maxicare (or other HMO) health card, can I still use my MyMaxicare Lite at the same time?

Yes. You may advise the Roving Specialist to coordinate with the hospital’s Billing Department for issuance of another LOA and that you will use your MyMaxicare Lite card.

15. Will I be able to utilize the remaining balance of my coverage should my availment did not reach Php 25 000?

No, the balance will no longer be used as this is just for one – time availment only. Once an LOA has been generated and issued, the card is already deactivated.

16. Can I give MyMaxicare Lite card to somebody else?

Yes, as long as it has not been registered yet to a particular person.

17. Should I have any inquiry, who can I call?

Feel free to call us at any of our contact points as seen on this page.

1. What is EReady?

It is a prepaid health card of Maxicare that provides one – time availment coverage, of up to Php 15000.00, for any Emergency cases.

2. What are the examples of an Emergency case or condition?

– An Emergency case is that of considered to be life – threatening or accidental injury or a sudden and unexpected onset of a condition or illness such as heart attack, cardiovascular or cerebrovascular accidents, loss of consciousness or respiration and convulsions.

– Illnesses or injuries requiring immediate medical attention to alleviate pain or discomfort.

3. What are the benefits of EReady?

EReady provides the following benefits:

– Coverage for Professional Fees, Emergency Room Fees, medicines used for the immediate relief and treatment of the condition, and laboratory and diagnostic procedures.

– Initial treatment of animal bites for the first 24 hours, vaccines for animal bites such as Rabies shot.

– Emergency case coverage for one – time availment of up to Php 15 000.00.

– Nationwide access to Maxicare – affiliated hospital providers.

– Life AD&D (Accidental Death and Dismemberment) up to Php 25 000.00 with Double Indemnity feature.

– 20% discount on basic dental procedures at any Metro Dental clinics and 15% discount on dermatology procedures at any MyHealth Clinics.

4. Who can avail of this prepaid health card?

This is available for purchase and usage to both Maxicare members and non – members aged 15 days to 65 years old.

5. How much does EReady costs?

– EReady is available in two (2) plans. While both plans have the same Maximum Benefit Limit of Php 15 000.00, the higher variant provides added comfort of having access to the major hospitals in Metro Manila.

Plan Type: Titanium
Cost (one-time payment only): Php 549.00
Access: Access to all Maxicare – affiliated hospitals nationwide, excluding the major* hospitals

Plan Type: Platinum
Cost (one-time payment only): Php 749.00
Access: Access to all Maxicare – affiliated hospitals nationwide, including the major* hospitals

*Six (6) identified, major hospitals: Asian Hospital & Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center – Quezon City, St. Luke’s Medical Center – Taguig, The Medical City.

6. Where can I buy EReady?

– You can buy EReady at any Robinsons Department Store – Business Centers nationwide.

– It is available through our Maxicare Account Officers. You may email Mishell Dalisay at mishell.dalisay@maxicare.com.ph.

– You may also avail through our accredited Agents and Brokers nationwide.

– We also have the following selling channels:

o Maria Health

  • o IRemit
7. How do I use my EReady?

Definitely, there is no need for paperworks. Registration is via SMS only. Just follow these steps below:

1.) Lightly scratch – off the gray panel found at the bottom of the signature panel to reveal the Medilink Number (starts with 1168).

2.) Register via SMS following this format: MAXIPREPAID < 1168 Card Number >#<First Name>#<Middle Initial>#<Last Name>#<Birthdate in MMDDYYYY format>#<Civil Status>.

3.) Send it to any of the following numbers: 0917.8989691 / 0917.7776565 / 0999.8886565.

4.) You will receive a notification of successful Membership Enrollment.

Once successfully registered, your MyMaxicare Lite membership will be activated seven (7) days from the time of registration.

Your card will be valid for one (1) year from the date of activation.

When emergency arises, present your MyMaxicare Lite together with a valid I.D. at any of our Maxicare – affiliated hospitals.

8. As this is an emergency case, can I avail at a non – affiliated hospital?

The EReady card uses the swipe facility of Maxicare affiliated hospitals for membership verification. In this case, availment should only be made in an affiliated provider to be able to be covered by the card.

9. Are there any exclusions or limitations in coverage?

– Yes, there are some items not covered by EReady. These include In – Patient availments leading to confinement, availment under Primary Care Emergency Room setting, transferring to other provider/s due to unavailability of procedure or facilities.

– All exclusions are listed in the EReady Card Kit.

10. Will I be able to utilize the remaining balance of my coverage should my availment did not reach Php 15 000?

No, the balance will no longer be used as this is just for one – time availment only. Once an LOA has been generated and issued, the card is already deactivated.

11. Am I allowed to buy more than one (1) EReady card?

Yes. However, you may only register the 2nd card three (3) months after your 1st card has been deactivated.

12. Can I give MyMaxicare Lite card to somebody else?

Yes, as long as it has not been registered yet to a particular person.

13. Should I have any inquiry, who can I call?

Feel free to call us at any of our contact points as seen on this page.

1. What career opportunity can I get from becoming a Maxicare Agent?

Here in Maxicare, you can become an accredited Health Benefit Agent (HBA) or even form your own unit as an Agency Unit Head.

2. How do I become an accredited Maxicare Agent?

Yes. You just have to submit your Application Form and the necessary requirements, attend our Product Training, Pass the Accreditation Exam and pay the Accreditation Fee.

3. What do I need to become an accredited Agency Unit?

– An Agency Unit must be composed of one (1) Agency Unit Head (AUH) and at least three (3) existing sub – agents.

– AUH and sub – agents must comply to and submit the necessary requirements as that of a regular Agent.

4. What are the needed documents for Accreditation?

a. Two (2) pcs. of Passport size or 2×2 picture in blue background color;
b. Two (2) pcs. of 1×1 picture in any background color;
c. Two (2) photocopies of two (2) Government- issued IDs with visible Signature;
d. Tax Identification Number (TIN);
e. Original and valid of any of the following clearances: NBI, Police or Barangay Clearance;
f. If an existing insurance agent, Certification or Insurance Commission – issued ID is accepted; and,
g. An active Savings account

5. Where do we go for Accreditation?

– You may go to our Head Office located at Maxicare Tower, 203 Salcedo Street, Legazpi Village, Makati City and look for Sharmaine Tabing.

– For regional applicants, you may email accreditation@maxicare.com.ph to know where to submit your Accreditation requirements and attend the training sessions.

6. What are the incentives that I can get from Maxicare?

– Aside from the commission Agents and Agency Units get from every sales production, other incentives include:
o Travel Package
o Awards / Recognitions and Cash Prizes

– Maxicare also comes up with incentive promos from time to time.

7. Will I be attending a Training Program?

Yes. An initial training session will be required for newly accredited Agents and Agency Units.

8. How will I be paid of commission?

Commission is paid every seven (7) working days from the date of payment of the account gotten by the Agent or Agency Unit. It is credited through the Equicom Debit Card, which you will be getting once you have become an Accredited Agent of Maxicare.

9. Who should we contact for Accreditation?

You may contact Sharmaine Tabing at (632) 908.6900 local 1164 to 65. Or email accreditation@maxicare.com.ph.

10. Is there a fee to be paid for Accreditation?

Yes. At a minimal licensing fee of Php 1000.00, this already includes the Maxicare’s Agent’s Kit composed of an I.D. card, a box of Business Cards, Product Manual, Polo Shirt and Folio Bag. However, there is an additional payment of Php 100.00 which is for the processing and initial Equicom Debit Card deposit.