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Salient Features

PLAN TYPE Room & Board MAXIMUM BENEFIT LIMIT (MBL)
Platinum Plus Large Private Php 200,000.00
Platinum Regular Private Php 150,000.00
Gold Regular Private Php 100,000.00
Silver Semi - Private Php 60,000.00

Healthcare Benefits

  • Room and Board Accommodation
  • Use of Operating Room, Intensive Care Unit (ICU), Isolation Room and Recovery Room
  • Professional fees of attending Physicians, Surgeons, Anesthesiologist and Cardio-pulmonary Specialist (for clearance before surgery and cardiac monitoring during surgery)
  • Standard nursing services
  • Medicines for In-patient care
  • Blood product transfusions and intravenous (IV) fluids
  • X-ray, laboratory examinations, diagnostic tests and therapeutic procedures incidental to confinement
  • Dressings, conventional casts (plaster of Paris) and sutures
  • Consultations
  • Treatment of minor injuries
  • X-ray, laboratory examinations, routine, diagnostic and therapeutic procedures
  • Minor surgery not requiring confinement
  • Eye laser therapy for retinal tear / hole / detachment and glaucoma
  • Cauterization of warts
  • Sclerotherapy (for varicose veins)
  • Speech Therapy (For Stroke patients only)
  • Allergy testing
  • Tuberculin test

Passive and active vaccines for treatment of tetanus and animal bites

A. Affiliated Hospital

  • Doctor’s services
  • Emergency Room fees
  • Medicines used for immediate relief and during treatment
  • Oxygen, intravenous (IV) fluids and blood products
  • Dressings, conventional casts (plaster of Paris) and sutures
  • X-rays, laboratory, diagnostic examinations and other medical services related to the emergency treatment of the patient

B. Non-Affiliated Hospital

  • Within the Philippines
    • Reimbursement up to 80% of the actual hospital bills and 80% of the Professional fees (based on Maxicare rates) incurred during the first twenty-four (24) hours of treatment up to Php 30,000.00 / availment / member.
  • Areas without accredited hospitals within the Philippines
    • Reimbursement of 100% of the total hospital bills and Professional fees (based on Maxicare rates)
  • Outside the Philippines
    • Maxicare shall reimburse 100% actual costs up to Php 30,000.00 / availment / member
  • Ambulance Service up to Php 2,500.00 per conduction
    • Life coverage with Accidental Death & Dismemberment
    • Scoliosis treatment
    • Congenital illness
    • Consultations for Chronic Dermatoses up to Benefit Limit
    • Transurethral Microwave Therapy of Prostate

Clinic-based Annual Check-Up, consist of five (5) basic routines: 

 

    • History and Physical Exam
    • Complete Blood Count (CBC)
    • Routine Urinalysis
    • Routine Fecalysis
    • Chest X-ray (PA and Lateral)
    • Annual Oral / Dental Examination and Consultation
    • Emergency Dental Treatment
    • Annual Oral Prophylaxis
    • Simple Tooth Extractions
    • Restorative and Prosthodontic Treatment Planning
    • Permanent fillings
    • Unlimited temporary fillings, as needed
    • Desensitization of hypersensitive teeth twice a year
    • Simple adjustment of dentures
    • Recementation of loose crowns, inlays or onlays
    • Dental nutrition and Dietary counseling
    • Dental Health Education
    • 24-hour Telephone Medical Advice
    • Emergency Medical Evacuation
    • Emergency Medical Repatrition
    • Repatrition of Mortal Remains

This corresponds to any condition that is considered to be chronic, progressive, life-threatening and which may entail lifelong therapy. This also refers to conditions where complete cure cannot be ensured.

Coverage For Dreaded and Non-Dreaded Conditions

General Terms & Conditions

Age Eligibility (for both Principals and Eligible Dependents): 15 days old to 60 years old

Eligible Dependents are as follows (in order):

  • For Single Principal Enrollees: Mother, Father, Siblings (21 years and 5 months old and below, according to age)
  • For Married Principal Enrollees: Spouse, Children (21 years and 5 months old and below, according to age)

Requirements:

  • Individual Membership
    • – Filled – up Application Form
    • – Medical Requirements, applicable only for enrollees aged 49 years and 6 months old and above
    • – Photocopy of Alien Certificate of Residency (ACR) if a Foreign national
  • Family Membership (Couples only)
    • – Filled – up Application Form
    • – Copy of Marriage Certificate
    • – Medical Requirements, applicable only for enrollees aged 49 years and 6 months old above
    • – Photocopy of Alien Certificate of Residency (ACR) if a Foreign national
  • (With Child Dependent)
    • – Filled – up Application Form
    • – Copy of Birth Certificate (per Child)
    • – Medical Requirements, applicable only for enrollees aged 49 years and 6 months old above
    • – Photocopy of Alien Certificate of Residency (ACR) if a Foreign national

Membership fees can be paid on an annual, semi-annual and quaterly basis

All benefits are subject to Maxicare’s General Exclusions and Conditions for eligible members

CONNECT WITH US

24/7 Customer Care Hotline
+ 632 582 1900 (PLDT)

+ 632 798 7777 (GLOBE)

 
24/7 Customer Care Email
customercare@maxicare.com.ph
 
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