28/07/2018
Health Care Benefits for Individual and Family Plan
IN-PATIENT 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 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
OUT- PATIENT CARE:
- 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
PREVENTIVE CARE:
- Passive and active vaccines for treatment of tetanus and animal bites
Affiliated Hospital
Doctorβs 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
EMERGENCY CARE:
A. 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)
B.Non- Affiliated Hospitals
*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
Clinic-based Annual Check-Up, consist of five (5) basic routines:
ANNUAL PHYSICAL EXAM:
- History and Physical Exam
- Complete Blood Count (CBC)
- Routine Urinalysis
- Routine Fecalysis
- Chest X-ray (PA and Lateral)
DENTAL CARE (Optional):
- 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
M.A Moreno
License #: A459809
Health Benefit Agent