Register 
Sign in 
Search
Register
Sign in
Hello! How can we help you?
How can we help?
Let us know how we can assist you
Looking for some answers?
Head on over to our
Frequently Asked Questions page
Want to talk to us?
Contact any of the numbers below to get in touch
Product Inquiry Hotline
24/7 Customer Care Email
24/7 Customer Hotline
Follow us
Downloadable Forms
Agents Accreditation Application FO-SS-010
Customer Information Form (CIF)
Auto Credit Arrangement Authorization Form – Reimbursement Non Medical
Broker Application Form FO-SS-0 016
Member & Card Maintenance Form
Statement of Lost ID Card
RT-PCR test
Member’s Virtual Playbook
Step by Step Guide in Availing your Benefits
Primary Care Network
BestLIFE Download sample
Group Policyholder’s Statement
Group Death Claimant’s Statement
Affidavit of Parental Care & Custody
Group Employer’s Statement
Group Death Attending Physician’s Statement
Deed of Extra Judicial Settlement
Affidavit of Self Adjudication
Special Power of Attorney
Downloadable Forms
Agents Accreditation Application FO-SS-010
Customer Information Form (CIF)
Auto Credit Arrangement Authorization Form – Reimbursement Non Medical
Broker Application Form FO-SS-0 016
Member & Card Maintenance Form
Statement of Lost ID Card
DOH-PSMID as of March 10, 2020
Member’s Virtual Playbook
Step by Step Guide in Availing your Benefits
Primary Care Network
BestLIFE Download sample
Group Policyholder’s Statement
Group Death Claimant’s Statement
Affidavit of Parental Care & Custody
Group Employer’s Statement
Group Death Attending Physician’s Statement
Deed of Extra Judicial Settlement
Affidavit of Self Adjudication
Special Power of Attorney
Need help understanding
certain terms?
Looking for an LOA?
A Letter of Authorization (LOA) is needed to visit all Maxicare affiliated hospitals that aren’t Primary Care Clinics
Need to get reimbursed?
We’re more than happy to help out
