Vous êtes sur la page 1sur 3

With PhilCares Health Vantage, receive

coverage starting at Php 40,000 up to Php


80,000 for emergency room care and
hospitalization
Choose your preferred benefit limit and room
& board, and enjoy unlimited availment for
one year, up to the plans benefit limit
Inclusive of: PHILCARE HEALTH VANTAGE

Emergency room fees


Room and board if case needs admission
HEALTH VANTAGE ADULTS
Doctorsand
Covers emergency professional
hospitalizationfees
up to plan limit (18 - 60 Years old)
Could also be used just for outpatient ERand
Laboratory, diagnostic, care therapeutic
procedures AGGREGATE
One year unlimited frequency of availment up to plan PLAN ROOM PREMIUM
BENEFIT LIMIT
Medicines (except vaccines) as medically
benefit limit
necessary during confinement except for Plan 40 40,000 Ward 3,750
Php 50,000 accidental death & dismemberment coverage
cases declared as non-coverable Plan 60 60,000 Semi-Private 5,950
Php 10,000 life insurance coverage
Special modalities of treatment which are Plan 80 80,000 Regular Private 9,950
Access to PhilCares accredited network
medically necessary during ER and
Covers room and board, animal bites except vaccines,
confinement and subject to standard
Special Modalities of treatment, Diagnostic and Therapeutic HEALTH VANTAGE KIDS
inner limits
(6 months - 17 years old)
procedures, during ER and confinement, Doctors profession- HEALTH VANTAGE ELI
Php 10,000 life insurance (ADULTS only)
al fees, Laboratory, diagnostic, and therapeutic procedures AGGREGATE
Php 50,000 accidental death and PLAN ROOM PREMIUM
Medicines (except vaccines) as medically necessary during BENEFIT LIMIT
dismemberment coverage (ADULTS only) Plan 40 40,000 Ward 3,850
confinement except for cases declared as non-coverable
Exclusive access to Go!Mobile App that lets
- Plan 60 60,000 Semi-Private 9,050
you check your health benefit packages and
Plan 80 80,000 Regular Private 13,950
steadfast search of affiliated hospitals
Participation in PhilCare's 360 health and
wellness programs
Card Validity is up to one (1) year upon activation
No medical examination required
No hospital deposit required
No hospital deposit required
www.mariaHealth.ph No medical examination required
For a list of 500+ PhilCare accredited
+632-759-9210
hospitals nationwide, visit Philcare's website:
hello@mariahealth.ph
www.philcare.com.ph
facebook.com/himariahealth
HEALTH VANTAGE FREQUENTLY ASKED QUESTIONS Do I need to have PhilHealth coverage? Additional hospital charges and professional fees
resulting from taking a room category higher than
Are there exclusions? PhilHealth coverage is require once admitted.
whats specified in members benefit schedule
However, for those who are not covered by Phil-
Health Vantage does not cover cerebrovascular
health, one may pay the PhilHealth portion of the Additional personal comfort items (i.e. phone, tv,
accidents (stroke) and injuries suffered because of
hospital bill before being discharged from the food trays, admission kit, etc)
members misconduct, voluntary participation in
hospital. Procurement or use of corrective appliances,
hazardous sport or activity and military service or
prosthesis, artifical aids and durable equipment
under conditions of war. Non-emergency, pre-ex-
such as stents, prolene meshm pins, screws, plates,
isting, congenital, maternity related and those NON-COVERED ILLNESSES AND DISEASES
wires, VP shunt, clips, hearing aids, intraocular lens,
conditions under PhilCares general exclusion list
For a full list of non-covered illnesses and diseases, eyeglasses, contact lenses, balloons, valves; braces,
are also not covered.
please check www.philcare.com.ph crutches, pace maker
Covered cases include acute cases of bacterial and
A. Diseases not covered, but not limited to All pregnancy-related conditions and complica-
viral infections such as appendicitis, bronchitis,
tions relating to mother and unborn child, requir-
gastritis, gastroenteritis, pharyngitis, pyelonephritis, Anal fistulae / Asthma / Auto immune conditions /
ing medical and surgical care, regardless of time/
urinary tract infections sinusitis, tonsilitis, upper Cardiovascular diseases / Calculi of the urinary sys-
date of occurence (during actual time of pregnan-
respiratory tract Infection, amoebiasis, cellulitis, tem / Cataracts / Sinus conditions requiring surgery
cy or thereafter)
dengue fever, pneumonia and typhoid fever. / Cerebrovascular diseases / Cholecystitis/cholelithi-
All sexually transmitted diseases
asis / Chronic skin conditions / Cirrhosis of the liver
For details, contact PhilCares Customer Hotline
/ Collagen disease / Degenerative conditions / Dia- Blood screnning, blood typing, cross-matching
at (02) 462-1800. Outside Metro Manila, please call
betes mellitus / DIseased tonsils requiring surgery for potential donors in relation to blood donation
1-800-1888-3230 toll-free for PLDT subscribers.
/ Endometriosis / Epilepsy / Gastric or duodenal and transfusion
ulcer / Hallux valgus / Hemorrhoids / Hernia / HIV/ All forms of behavioral disorders whether con-
Can I still use the remaining balance if availment is AIDS / Hypertension / Neurological conditions / genital or acquired; developmental or psychiatric
below the benefit limit? Obesity, dyslipidemia and other metabolic condi- disorder; psychosomatic illness
As long as the total plan benefit limit is not yet tions / Pathological abnormalities of nasal septum Any injury , illness or condition which the mem-
consumed, there is no limit on the number of and turbinates / Thyroid conditions / Tuberculosis ber may suffer after he has taken intoxicating
times you may use your Health Vantage card with- / Tumors, whether benign or malignant of all drugs or alcoholic beverage as evidenced by
in a year organs and organ systems, including malignancing clinical history or alcoholic breath as determined
of the blood or bone marrow / Non-emergency by the examining physician and/or conditions
Is there a limit on the number of times I can register a
case during point of availment Pre-existing and or illnesses resulting from alcoholism and drug
prepaid health card in my name?
congenital conditions addiciton.
There is no limit to the number of Health Vantage
B. General Exclusions Medical or surgical procedures that are experi-
cards that you may register in your name within
mental in nature and those that are not generally
a year. However, you can only register the sec- Care by non-affiliated physician in either affiliat-
accepted as standard medical treatment by the
ond card after the first card has been used. There ed
medical profession, that may include but is not
should only be one active card at any given time. or non-affiliated hospitals
limited to Chiropractic Services, Acupuncture, and
Care by an affiliated physician in a non-affiliated
Reflexology
hospital
Allergens used for hypersensitivity testing regard- specialize equipments
less if administed as an outpatient or inpatient All diseases declared as epidemic by the Depart-
procedure ment of Health (DOH) and any other recognized
Treatment of injuries or illnesses resulting from health agencies.
voluntary participation of a member in any haz- All hospital charges and professional fees in-
ardous sport or activity that may include: bungee curred after the day and time the discharge from
jumping, scuba diving, hang-gliding, mountain hospital has been duly authorized
climbing, parachuting, surfing, rock climbing,
paintballing, boxing, wrestling, martial arts, gym-
nastics, motorsports, wakeboarding, waterskiing,
HOW TO USE
and all other voluntary acitivities which pose a
Step 1:
grave danger to life and limb. Upon payment confirmation, Maria Health will
Treatment of injuries or illnesses due to military email you PhilCares Health Vantage enrollment
service or suffered under conditions of war form and next steps

Treatment of injuiries or illnesses wherein the NOTE: You cannot register for a Health Vantage
care or reimbursement of services is provided by card if you have existing PhilCare coverage or
law or a government program, up to limits over age eligibility.
Treatment of any injury which is proven to be at-
Step 2:
tributable to the members own misconduct such Once form is submitted and approved, your
as negligence, intemperate use of drugs or alco- health card will be delivered.
holic liquor, direct or indirect participation in the
Step 3:
commission of a crime, whether consummated
To avail, simply present your card with a valid
or not, violation of a law or odinance, unnecessary identification to the emergency room staff at any
exposure to imminent danger or hazard to health, PhilCare accredited hospital.
including fireworks related injuries, infections or
complications as a resut of tattoos and piercing
of the ear or any body part, whether self-inflicted
or done by a third party, or attempted suicide or
self-destruction, whether sane or insane
All cases of assault perpetrated by the Member
including domestic violence which result in the
harm or injury to the Member perpetrator
Vaccines, whether elective or adminstered
during an emergency treatment are not covered
Inpatient pain management necessitating spe-
cialzied pain management team and/or the use

maria

Vous aimerez peut-être aussi