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Benefits and Coverage

Explore exclusive benefits and personalized services. Maxicare offers members a variety of quality inpatient and outpatient services for easy access to the care they need to live their best lives.

Member Section - Benefits and Coverage
Inpatient care
  • 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 inpatient 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
Outpatient care
  • X-ray, laboratory examinations, routine, diagnostic and therapeutic procedures
  • Consultations
  • Treatment of minor injuries
  • 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
Preventive care

Passive and active vaccines for treatment of tetanus and animal bites

Emergency care

Any life-threatening or unexpected onset of a condition or illness, which requires the immediate alleviation of pain or discomfort within 24 hours including confinement in a regular private room.

Affiliated Hospital

  • Doctor’s services
  • Consultations
  • 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

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 ₱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 ₱30,000.00 / availment / member

Ambulance Service up to ₱2,500.00 per conduction

Additional benefits
  • Life coverage with Accidental Death & Dismemberment
  • Scoliosis treatment
  • Congenital illness
  • Consultations for Chronic Dermatoses up to Benefit Limit
  • Transurethral Microwave Therapy of Prostate
Annual Check-Up (ACU) - Available to all plan types

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

  • History and physical exam
  • CBC (Complete Blood Count)
  • Routine Urinalysis
  • Routine Fecalysis
  • Chest x-ray (PA and lateral)
Dental care (optional)