Comparative Rates and Benefits

MAXICARE
(10-19 Heads)
MEMBER TYPE OPTION
MAXIMUM BENEFIT
ROOM & BOARD
LIMIT
1 SMALL SUITE 350,000
2 OPEN PRIVATE 250,000
3 LARGE PRIVATE 200,000

PRINCIPAL
4 REGULAR PRIVATE 110,000
5 SEMI-PRIVATE 90,000
1 SMALL SUITE 350,000
2 OPEN PRIVATE 250,000
3 LARGE PRIVATE 200,000

DEPENDENTS
4 REGULAR PRIVATE 110,000
Maxicare Mplus best suits for companies with 10-19 employees.

OVERALL comprehensive package that covers Pre-existing conditions up to M
Benefit Limit
Hospital 578
ACCREDITED PROVIDERS Clinics 792
Doctors 60,256
MAXICARE
10-19 Heads) (20-99 Heads)
MAXIMUM BENEFIT
ANNUAL RATES ROOM & BOARD ANNUAL RATES
LIMIT
34,815 SMALL SUITE 350,000 29,642
29,798 OPEN PRIVATE 250,000 25,281
28,199 LARGE PRIVATE 200,000 23,869
23,913 REGULAR PRIVATE 110,000 20,337
19,773 SEMI-PRIVATE 90,000 16,858
19,261 SEMI-PRIVATE 80,000 16,426
47,211 SMALL SUITE 350,000 40,057
39,987 OPEN PRIVATE 250,000 33,842
38,101 LARGE PRIVATE 200,000 32,258
32,819 REGULAR PRIVATE 110,000 27,818
26,361 SEMI-PRIVATE 90,000 22,391
25,848 SEMI-PRIVATE 80,000 21,961
nies with 10-19 employees. This is a Maxicare Mplus best suits for companies with 20-99 employees. This is a
-existing conditions up to Maximum comprehensive package that covers Pre-existing conditions up to Maximum
Limit Benefit Limit
578 Hospital 578

792 Clinics 792
60,256 Doctors 60,256
PHILCARE PHILCARE
(SME LUXE 5-19) (SME LUXE 20-
MAXIMUM BENEFIT
ROOM & BOARD ANNUAL RATES ROOM & BOARD
LIMIT
SUITE 4,000 400,000 28,583 SUITE 4,000
SUITE 3,000 400,000 26,309 SUITE 3,000
OPEN PRIVATE 250,000 22,428 OPEN PRIVATE
REGULAR PRIVATE 250,000 19,320 REGULAR PRIVATE
SEMI-PRIVATE 200,000 15,546 SEMI-PRIVATE
WARD 100,000 12,057 WARD
SUITE 4,000 400,000 38,237 SUITE 4,000
SUITE 3,000 400,000 35,426 SUITE 3,000
OPEN PRIVATE 250,000 29,753 OPEN PRIVATE
REGULAR PRIVATE 250,000 25,716 REGULAR PRIVATE
SEMI-PRIVATE 200,000 20,284 SEMI-PRIVATE
WARD 100,000 15,854 WARD
SME Luxe best suits for companies with 5-19 employees. This is a SME Luxe best suits for companies with
comprehensive package that covers Pre-existing conditions up to Maximum comprehensive package that covers Pre-exi
Benefit Limit Benefit Lim
Hospital 619 Hospital

Clinics 1,088 Clinics
Doctors 51,344 Doctors
COMPARATIVE RATES & BENEFITS ANAL
PHILCARE EASTWEST
(SME LUXE 20-150) ( ROYAL HEALTH ADVANTAGE 5-25)
MAXIMUM BENEFIT MAXIMUM BENEFIT
ANNUAL RATES ROOM & BOARD
LIMIT LIMIT
400,000 24,506 LARGE PRIVATE 100,000
400,000 22,591 REGULAR PRIVATE 100,000
250,000 19,180 REGULAR PRIVATE 75,000
250,000 16,649 SEMI-PRIVATE 75,000
200,000 13,452 SEMI-PRIVATE 60,000
100,000 10,372 WARD 50,000
400,000 32,615 LARGE PRIVATE 100,000
400,000 30,252 REGULAR PRIVATE 100,000
250,000 25,355 REGULAR PRIVATE 75,000
250,000 22,025 SEMI-PRIVATE 75,000
200,000 17,428 SEMI-PRIVATE 60,000
100,000 13,569 WARD 50,000
e best suits for companies with 20-150 employees. This is a Royal Health Advantage targets companies with 5-25 employees whose age a
ve package that covers Pre-existing conditions up to Maximum is within 35 years old. This package includes intensive benefits that includes
Benefit Limit existing conditions up to MBL except for dreaded conditions
619 Hospital 450

1,088 Clinics 539
51,344 Doctors 26,000
ATIVE RATES & BENEFITS ANALYSIS
WEST EASTWEST
DVANTAGE 5-25) ( ROYAL HEALTH ADVANTAGE 26-99)
MAXIMUM BENEFIT
LIMIT
16,854 LARGE PRIVATE 100,000 13,596
16,180 REGULAR PRIVATE 100,000 13,114
15,430 REGULAR PRIVATE 75,000 12,634
11,996 SEMI-PRIVATE 75,000 9,698
11,547 SEMI-PRIVATE 60,000 9,249
8,247 WARD 50,000 6,593
17,977 LARGE PRIVATE 100,000 19,893
16,572 REGULAR PRIVATE 100,000 18,300
15,822 REGULAR PRIVATE 75,000 17,551
11,678 SEMI-PRIVATE 75,000 12,910
11,229 SEMI-PRIVATE 60,000 12,461
7,689 WARD 50,000 8,545
with 5-25 employees whose age average Royal Health Advantage targets companies with 26-99 employees whose age
des intensive benefits that includes Pre- average is within 35 years old. This package includes intensive benefits that include
except for dreaded conditions Pre-existing conditions up to Maximum Benefit Limit
450 Hospital 450

539 Clinics 539
26,000 Doctors 26,000
PHILBRITISH INLIFE
( PRIME 10-99) ( BIZ PRIMER 3
MAXIMUM BENEFIT
ROOM & BOARD ANNUAL RATES ROOM & BOARD
LIMIT
X X X REGULAR PRIVATE
OPEN PRIVATE 150,000 15,330 SEMI-PRIVATE
REGULAR PRIVATE 100,000 11,700 SEMI-PRIVATE
SEMI-PRIVATE 80,000 9,570 WARD
WARD 50,000 7,000 WARD
OPEN PRIVATE 150,000 17,170 SEMI-PRIVATE
REGULAR PRIVATE 100,000 13,105 SEMI-PRIVATE
SEMI-PRIVATE 80,000 10,720 WARD
WARD 50,000 7,840 WARD
SME PRIME best suits for companies with 10-99 employees. This is a New InHealth Biz Primer is a compreh
comprehensive package that covers Pre-existing conditions up to Maximum competitive premium rates that is perfe
Benefit Limit employees
Hospital 619 Hospital

Clinics 1,088 Clinics
Doctors 51,344 Doctors
INLIFE etiQa
( BIZ PRIMER 3-99) ( MedProtectPlus 5-99)
MAXIMUM BENEFIT MAXIMUM BENEFIT
ANNUAL RATES ROOM & BOARD
LIMIT LIMIT
200,000 18,120 SUITE 4,000 200,000
150,000 17,420 OPEN PRIVATE 150,000
150,000 12,720 REGULAR PRIVATE 150,000
100,000 11,440 REGULAR PRIVATE 100,000
100,000 10,515 SEMI-PRIVATE 75,000
75,000 10,005 WARD 50,000
200,000 24,010 SUITE 4,000 200,000
150,000 23,085 OPEN PRIVATE 150,000
150,000 14,950 REGULAR PRIVATE 150,000
100,000 13,445 REGULAR PRIVATE 100,000
100,000 12,095 SEMI-PRIVATE 75,000
75,000 11,510 6 50,000
alth Biz Primer is a comprehensive quality healthcare with MedProtectPlus best suits for companies with 5-99 employees. This
ive premium rates that is perfect for companies of up to 99 comprehensive package that covers Pre-existing conditions up to Max
employees Benefit Limit
533 Hospital 685

950 Clinics 1,013
43,281 Doctors 30,844
a INTELLICARE
Plus 5-99) (FIT PROGRAM 10-99)
MAXIMUM BENEFIT
LIMIT
60,700 OPEN PRIVATE 250,000 29,667
43,690 OPEN PRIVATE 150,000 25,889
37,769 REGULAR PRIVATE 120,000 23,954
29,235 REGULAR PRIVATE 100,000 21,737
17,928 SEMI-PRIVATE 80,000 15,226
14,095 WARD 60,000 13,703
60,700 OPEN PRIVATE 250,000 34,117
43,690 OPEN PRIVATE 150,000 29,772
37,769 REGULAR PRIVATE 120,000 27,547
29,235 REGULAR PRIVATE 100,000 24,998
17,928 SEMI-PRIVATE 80,000 17,508
14,095 WARD 60,000 15,758
nies with 5-99 employees. This is a Fit Program best suits for companies with 10-99 employees. This is a
-existing conditions up to Maximum comprehensive package that covers Pre-existing conditions up to Maximum
Limit Benefit Limit
685 Hospital 614

1,013 Clinics 814
30,844 Doctors 58,535
FEATURES MAXICARE PHILCARE
MAJOR HOSPITAL ACCESS
1 St. Luke's Global (BGC) With Access With Access
2 St. Luke's Quezon City (QC) With Access With Access
3 Asian Hospital and Medical Center With Access With Access
4 Makati Medical Center With Access With Access
5 The Medical City With Access With Access
6 Cardinal Santos Medical Center With Access With Access
7 Cebu Doctors’ Hospital With Access With Access
8 Chong Hua Hospital With Access With Access
9 Davao Doctors Hospital With Access With Access
ANNUAL PHYSICAL EXAMINATIONS

1 Physical Exam Covered Covered
2 CBC Covered Covered
3 Urinalysis Covered Covered
4 Fecalysis Covered Covered
5 Chest X-ray Covered Covered
6 ECG (35 years old and up) Covered Covered
7 Pap Smear for Females (35 years old and up) Covered Covered
8 Mobile APE/On-site APE Covered Covered
PREVENTIVE CARE
1 Wellness Program Covered Covered
2 Periodic monitoring of health problems Covered Covered
3 Health-education and counselling on diets or exercise Covered Covered
4 Health habits and Family Planning counseling Covered Covered
Passive and active vaccines for treatment of tetanus and
5 Up to Php 20,000/member/year Up to Php 20,000/member/year
animal bites
OUT-PATIENT BENEFITS
1 Referral to specialists Up to MBL Up to MBL
2 Regular Consultations and treatment (except prescribed medic Up to MBL Up to MBL
3 Eye, Ear, Nose and Throat treatment Up to MBL Up to MBL
4 Treatment of minor injuries and surgery not requiring confin Up to MBL Up to MBL
5 X-ray and laboratory examinations prescribed by MediCard phy Up to MBL Up to MBL
6 Laser treatment for glaucoma and retinal detachment Up to MBL Up to MBL
Cataract extraction (including phacoemulsification) excluding
7 Up to MBL Up to MBL
the
Pre cost of lens
and post natal consultations excluding laboratory
examinations
9 Sclerotherapy (excluding sclerosing agent) Up to P5,000/leg/member/year Up to P5,000/leg/member/year
10 Cauterization of warts Up to P1,000/member/year Up to P1,000/member/year
11 Allergy testing up to P2,500.00 per member per year. Up to P2,500/member/year Up to P2,500/member/year
12 Tuberculin test (excluding screening) Up to P1,000/member/year Up to P1,000/member/year
IN-PATIENT BENEFITS
1 No deposit upon admission Covered Covered
2 Room & Board according to type of enrollment Covered Covered
3 Use of operating theatre and Recovery Room Covered Covered
Services of providerspecialist like anesthesiologist, internists,
4 Services Covered Covered
surgeons,and
andmedications
etc. for general/spinal anesthesia or
5 other forms of anesthesia deemed necessary for a surgical Covered Covered
6 procedure
Fresh whole blood transfusions and its processing/ screening a Covered Covered
7 X-ray and laboratory examinations Covered Covered
8 Administered medicines Covered Covered
9 Dressings, plaster casts, sutures and other items directly Covered Covered
related to the medical management of the patient
10 ICU confinements up to the dreaded disease limit per member Covered Covered
Human blood products (e.g. platelets, packed RBC) and its
11 Covered Covered
processing/screening except gamma globulin
12 Admission kit including wee bag Covered Covered
Room upgrade in case of room unavailability (Emergency
13 Up to 24 hours Up to 24 hours
case leading to confinement)
DIAGNOSTIC / THERAPEUTIC PROCEDURES

1 All diagnostic / therapeutic procedures medically necessary fo Up to MBL Up to MBL
2 Dialysis Up to 12 sessions/member/year Up to 12 sessions/member/year
3 Non-oral chemotherapy (for cancer treatment only) Up to MBL Up to MBL
4 Oral chemotherapy (for cancer treatment only) Up to MBL Up to MBL
5 Speech
Physicaltherapy
therapy / Occupational therapy excluding Up to 12 sessions (reimbursement basis) Up to Php 10,000 / member / year
6 subspecialties such as cardiac rehabilitation, pulmonary Up to 12 sessions/member/year Up to 12 sessions/member/year
7 rehabilitation and the like.
Therapeutic Radiology: Up to MBL Up to MBL
a. Brachytherapy Up to MBL Up to MBL
b. Cobalt Up to MBL Up to MBL
c. Linear Accelerator Therapy Up to MBL Up to MBL
d. Radioactive Cesium Up to MBL Up to MBL
e. Radioactive Iodine Up to MBL Up to MBL
8 Transurethral Microwave Therapy of Prostate Up to 25,000/member/year Up to 25,000/member/year
9 Stapled Hemorrhoidectomy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
10 Mammotome Up to MBL (Enhanced Benefit) Up to P5,000/member/year
11 4D Ultrasound except for maternity-related cases Up to MBL (Enhanced Benefit) Up to P5,000/member/year
12 Esophageal Manometry Up to MBL (Enhanced Benefit) Up to P5,000/member/year
13 Intensified Modulated Radiotheraphy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
Botox which is not cosmetic in nature nor for beautification
14 Up to P5,000/member/year Up to P5,000/member/year
purpose
15 Positron Emission Tomography (PET) Scan Up to MBL (Enhanced Benefit) Up to P5,000/member/year
16 CT Pulmonary Angiography Up to MBL (Enhanced Benefit) Up to P5,000/member/year
New Modalities/New Procedures
1 a. Photodynamic Therapy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
2 b. Acoustic Radiation Force Up to MBL (Enhanced Benefit) Up to P5,000/member/year

3 c. Alpha Globin/ Globulin Genotyping Up to MBL (Enhanced Benefit) Up to P5,000/member/year
4 d. Anchored Periplasmic
e. Antivascular Expression
Endothelial (APEx)-2
Growth Factor Hyrbid
(VEGF) drugs Up to MBL (Enhanced Benefit) Up to P5,000/member/year
5 (Avastin, Lucentis, Macugen) for Retinopathy, Macular Up to MBL (Enhanced Benefit) Up to P5,000/member/year
f. BCR-ABL by Quantitative
Degeneration Real-time
and other Optha Polymerase Chain
indications
6 Up to MBL (Enhanced Benefit) Up to P5,000/member/year
Reaction (QRT-PCR, RT-PCR)
7 g. Beta Globin/ Globulin Genotyping Up to MBL (Enhanced Benefit) Up to P5,000/member/year
8 h. Capsule Endoscopy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
9 i. Coblation Procedures Up to MBL (Enhanced Benefit) Up to P5,000/member/year
10 j. Continuous Renal Replacement Therapy (CRRT) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
11 k. Contrast Enhanced Ultrasound Up to MBL (Enhanced Benefit) Up to P5,000/member/year
12 l. Contrast Enhanced Fluorodeoxyglucose FDG PET Scan Up to MBL (Enhanced Benefit) Up to P5,000/member/year
13 m. Ductoscopy (Breast) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
14 n. Duolink In-Situ Fluoresence Hybridization (DISH) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
15 o. Endoscopic Ultrasound Up to MBL (Enhanced Benefit) Up to P5,000/member/year
16 p. Endovenous Laser Treatment Up to MBL (Enhanced Benefit) Up to P5,000/member/year
17 q. Endovenous Laser Ablation Up to MBL (Enhanced Benefit) Up to P5,000/member/year
18 r. Enhanced Fluorescent Protein Voltage Sensor (VPSP2.1) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
19 s. Enhanced Luciferase Complementation Up to MBL (Enhanced Benefit) Up to P5,000/member/year
20 t. Enzymed-linked Immunosorbent Spot (ELLISPOT) Assay Up to MBL (Enhanced Benefit) Up to P5,000/member/year
u. Epidermal Growth Factor Receptor (EGFR) Mutation
Assay / Test
22 v. ESAT-6 and CFP-10 Antigens Up to MBL (Enhanced Benefit) Up to P5,000/member/year
23 w. Fluorescence In-Situ Hybridization (FISH) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
24 x. Gastric Electrical Stimulation Technology Up to MBL (Enhanced Benefit) Up to P5,000/member/year
25 y. Image-guided Surgery / Radiotherapy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
26 z. Infrared Coagulation Hemorrhoidectomy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
27 aa. Infrared Thermography Up to MBL (Enhanced Benefit) Up to P5,000/member/year
28 ab. Intravenous Ultrasound Up to MBL (Enhanced Benefit) Up to P5,000/member/year
29 ac. JAK-2 Mutation Up to MBL (Enhanced Benefit) Up to P5,000/member/year
30 ad. Karyotyping Up to MBL (Enhanced Benefit) Up to P5,000/member/year
31 ae. KRAS Testing Up to MBL (Enhanced Benefit) Up to P5,000/member/year
32 af. Magnetic Resonance Spectroscopy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
33 ag. Mammotome or Vacuum Assisted Breast Biopsy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
ah. Monoclonal Antibody Therapy for Autoimmune
(Note: Certain Up to MBL (Enhanced Benefit) Up to P5,000/member/year
34 conditions andMonoclonal Antibodies
Rheumatological have
Diseases
immunosuppressive properties and this led to their
therapeutic application (monoclonal antibody therapy) in Up to MBL (Enhanced Benefit)
35 autoimmune
ai. Multiphotonconditions
imaging and rheumatologic diseases, such as Up to MBL (Enhanced Benefit) Up to P5,000/member/year
SLE, ankylosing spondylosis, rheumatoid arthritis, etc.)
36 aj. Multislice / multidetector/ spiral / multirow CT Up to MBL (Enhanced Benefit) Up to P5,000/member/year
37 ak. Neutral Commet Assay Up to MBL (Enhanced Benefit) Up to P5,000/member/year
38 al. Optical Glutamate Sensor Up to MBL (Enhanced Benefit) Up to P5,000/member/year
39 am. Parkinson's Profile Up to MBL (Enhanced Benefit) Up to P5,000/member/year
an. Percutaneous Discectomy CT Guided Intradiscal
Electrothermal Ablation Technic (IDET)
41 ao. Peritonial Dialysis Adequacy Test Up to MBL (Enhanced Benefit) Up to P5,000/member/year
42 ap. Peritoneal Equilibrium Test Up to MBL (Enhanced Benefit) Up to P5,000/member/year
43 aq. phaA and phaB genes test Up to MBL (Enhanced Benefit) Up to P5,000/member/year
44 ar. Pharmacoscintigraphy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
45 as. Philadelphia chromosome Up to MBL (Enhanced Benefit) Up to P5,000/member/year
46 at. Photodynamic Glutamate Sensor Up to MBL (Enhanced Benefit) Up to P5,000/member/year
47 au. Platelet Aggregation Test Up to MBL (Enhanced Benefit) Up to P5,000/member/year
48 av. Polymerase Chain Reaction (PCR) for katG and rpoB Up to MBL (Enhanced Benefit) Up to P5,000/member/year
aw. Polymerase Chain Reaction Single Strand Confirmation
Polymorphism (PCR-SCCP)
50 ax. QuantiFERON Tuberculosis (QFTB) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
51 ay. Radiofrequency Ablation (RFA) and other RF procedures Up to MBL (Enhanced Benefit) Up to P5,000/member/year
52 az. Renal Denervation Up to MBL (Enhanced Benefit) Up to P5,000/member/year
53 ba. Reverse Transcription Polymerase Chain Reaction (RT- Up to MBL (Enhanced Benefit) Up to P5,000/member/year
PCR)
54 bb. Robotic Surgery / Robotically assisted Surgery Up to MBL (Enhanced Benefit) Up to P5,000/member/year
55 bc. Single Incision Laparoscopy Surgery (SILS) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
56 bd. Spinal Angiogram Up to MBL (Enhanced Benefit) Up to P5,000/member/year
57 be. Stereotactic Breast Biopsy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
58 bf. Stereotactic Radiation Therapy/ Stereotactic Radiosurgery Up to MBL (Enhanced Benefit) Up to P5,000/member/year
59 bg. Supramagnetic Ion Oxide (SPIO)- enhanced MRI Up to MBL (Enhanced Benefit) Up to P5,000/member/year
60 bh. Transarterial Hemorrhoidal Dearterialization (THD) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
61 bi. Terahertz Imaging Up to MBL (Enhanced Benefit) Up to P5,000/member/year
62 bj. Three-Dimensional Conformal Radiotherapy (3DCRT) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
63 bk. Thyroplasty Up to MBL (Enhanced Benefit) Up to P5,000/member/year
64 bl. Tomotherapy Up to MBL (Enhanced Benefit) Up to P5,000/member/year
65 bm. Tractography Up to MBL (Enhanced Benefit) Up to P5,000/member/year
66 bn. Ultrafast Electron Beam Computed Tomography Up to MBL (Enhanced Benefit) Up to P5,000/member/year
67 bo. Ultroid Hemorrhoid Management Up to MBL (Enhanced Benefit) Up to P5,000/member/year
68 bp. Vulcan EAS (Electro Thermal Arthroscopy System) Up to MBL (Enhanced Benefit) Up to P5,000/member/year
SPECIAL MODALITIES OF TREATMENT

1 Laparoscopic Cholecystectomy Up to MBL Up to MBL
2 Lithotripsy Up to MBL Up to MBL
3 Magnetic Resonance Imaging (MRI) Up to MBL Up to MBL
4 Use of Nuclear/Radioactive Isotopes Up to MBL Up to MBL
5 Hysterescopic Myoma Resection Up to MBL Up to MBL
6 Laparoscopic Adrenalectomy (Unilateral) Up to MBL Up to MBL
7 Laparoscopic Adrenalectomy (Bilateral) Up to MBL Up to MBL
13 Cryosurgery Not Covered Not Covered
14 Sleep Study/Polysomnograms (Sleep Recording) Up to MBL Up to MBL
Continuous Positive Airway Pressure (CPAP) titration for
15 Up to 60K/member/year Up to 60K/member/year
sleep study
16 Neuroscan Not Covered Not Covered
17 Pelvic Laparoscopy Not Covered Not Covered
18 Angiography Up to MBL Up to MBL
19 Thallium Stress Testing Not Covered Not Covered
20 Radionuclide/Thyroid Scan Up to MBL Up to MBL
21 Pyrosphosphate Scintigraphy Not Covered Not Covered
22 Radio Isotope Scanning Up to MBL Up to MBL
23 Thalium scintigraphy Up to MBL Up to MBL
24 Pulmonary perfusion scan Up to MBL Up to MBL
25 Endoscopy Up to MBL Up to MBL
26 Densitometry Scan Up to MBL Up to MBL
27 Anti-Nuclear Anti-Body (ANA)** Up to MBL Up to MBL
28 C-Reactive Protein (Rheumatic and its complications) Up to MBL Up to MBL
29 Lupus cell exam Up to MBL Up to MBL
EMERGENCY CARE
1 In Affiliated Hospitals
a. Doctor’s services Up to Maximum Benefit Limit Up to Maximum Benefit Limit
b. Emergency Room Fees Up to Maximum Benefit Limit Up to Maximum Benefit Limit
c. Medicines used for immediate relief during treatment Up to Maximum Benefit Limit Up to Maximum Benefit Limit
d. Oxygen, Intravenous fluids and blood products. Up to Maximum Benefit Limit Up to Maximum Benefit Limit
e. Dressings, conventional casts (plaster of Paris) and
f. X-Rays, laboratory and diagnostic examinations, and Up to Maximum Benefit Limit Up to Maximum Benefit Limit
sutures.
other medical services related to the emergency treatment Up to Maximum Benefit Limit Up to Maximum Benefit Limit
of the patient.
g. Room Upgrade in case of room unavailability Up to 24 hours except Suite Room Up to 24 hours except Suite Room
Up to MBL via reimbursement based Up to MBL via reimbursement based
2 In Non-Affiliated Hospitals
Up to MBLonviathe HMO rates based Up to MBLonviathe
reimbursement HMO rates based
reimbursement
3 Outside the Philippines
4 Areas w/o Affiliated Hospital Up to MBLonviathe HMO rates based Up to MBLonviathe
reimbursement
Ambulance Service (Affiliated Hospital/Clinic to Affiliated on the HMO rates on the HMO rates
Hospital/Clinic).
Ambulance Service (Non-Affiliated Hospital/Clinic to Affiliated
6 Up to P2,500 per conduction Up to P2,500 per conduction
Hospital/Clinic)
OTHER BENEFITS
Initial Treatment within 24 hours from time of bite of Animal
1 Up to MBL (except cost of vaccines) Up to MBL (except cost of vaccines)
bites (under ER and OP only)
Scoliosis including necessary procedures, except physical
2 therapy sessions, whether congenital, pre-existing, Up to 60,000/member year Up to 60,000/member year
developmental or acquired
Congenital Conditions except physical therapy sessions and
3 Up to 60,000/member year Up to 60,000/member year
developmental disorders.
4 Hepatitis B except vaccines and screening Up to MBL Up to MBL
5 HIV/AIDS coverage Not Covered Not Covered
6 Out-Of-Network Access/Point Of Service Not Covered Not Covered
DENTAL BENEFITS
1 Annual Dental examination and consultation Covered Covered
2 Emergency Out-patient Dental Treatment - to be availed at Covered Covered
Affiliated dental clinics only
3 Oral prophylaxis Once a year Twice a year
4 Simple tooth extractions Covered Covered
5 Restorative and prosthodontic treatment planning Covered Covered
6 Temporary Fillings Unlimited, As needed Unlimited, As needed
7 Desensitization of hypersensitive teeth up to 2 teeth up to 2 teeth
8 Simple adjustment of dentures Covered Covered
9 Re-cementation of loose crowns, inlays and onlays Covered Covered
10 Dental Nutrition and Dietary Counseling Covered Covered
11 Dental Health Education Covered Covered
12 Pre-natal check of teeth and gums Covered Covered
13 Temporo Mandibular Joint Consultation Covered Covered
14 Gum treatment for cases like inflammation or bleeding Covered Covered
15 Permanent fillings Light cure up to 2 teeth up to 2 teeth
FINANCIAL ASSISTANCE
1 Natural Death P50,000.00 P10,000.00
2 Accidental Death P50,000.00 P20,000.00
PHILIPPINE BRITISH
EASTWEST INLIFE ETIQA
(PBAC)
With Access With Access With Access With Access

Covered Covered Covered Covered


Up to Php 20,000/member/year Up to Php 20,000/member/year Up to Php 20,000/member/year Up to Php 20,000/member/year
Up to MBL Up to MBL Up to MBL Up to MBL

Up to P5,000/leg/member/year Up to P5,000/leg/member/year Up to P5,000/leg/member/year Up to P5,000/leg/member/year
Up to P1,000/member/year Up to P1,000/member/year Up to P1,000/member/year Up to P1,000/member/year

Up to 24 hours Up to 24 hours Up to 24 hours Up to 24 hours

Up to 12 sessions/member/year Up to 12 sessions/member/year Up to 12 sessions/member/year Up to MBL (Enhanced Benefit)
Up to Php 10,000 / member / year Up to Php 10,000 / member / year Up to Php 10,000 / member / year Up to MBL (Enhanced Benefit)
Up to 12 sessions/member/year Up to 12 sessions/member/year Up to 12 sessions/member/year Up to MBL (Enhanced Benefit)
Up to 25,000/member/year Up to 25,000/member/year Up to 25,000/member/year Up to 25,000/member/year
Up to P5,000/member/year Up to P5,000/member/year Up to P5,000/member/year Up to MBL (Enhanced Benefit)



Not Covered Not Covered Not Covered Up to MBL (Enhanced Benefit)
Up to 60K/member/year Up to 60K/member/year Up to 60K/member/year Up to 60K/member/year
Up to Maximum Benefit Limit Up to Maximum Benefit Limit Up to Maximum Benefit Limit Up to Maximum Benefit Limit
Up to 24 hours except Suite Room Up to 24 hours except Suite Room Up to 24 hours except Suite Room Up to 24 hours except Suite Room
Up to MBL via reimbursement based Up to MBL via reimbursement based Up to MBL via reimbursement based Up to MBL via reimbursement based
reimbursement HMO rates based Up to MBLonviathe
reimbursement
reimbursement
on the HMO rates on the HMO rates on the HMO rates on the HMO rates
Up to P2,500 per conduction Up to P2,500 per conduction Up to P2,500 per conduction Up to P2,500 per conduction
Up to MBL (except cost of vaccines) Up to MBL (except cost of vaccines) Up to MBL (except cost of vaccines) Up to MBL (except cost of vaccines)
Up to 60,000/member year Up to 60,000/member year Up to 60,000/member year Up to 60,000/member year
Up to 60,000/member year Up to 60,000/member year Up to 60,000/member year Up to 60,000/member year

Not Covered Not Covered Not Covered Covered up to 30% of MBL
Not Covered Not Covered Not Covered Covered (Enhanced Benefit)

Twice a year Twice a year Twice a year Twice a year
Unlimited, As needed Unlimited, As needed Unlimited, As needed Unlimited, As needed
up to 2 teeth up to 2 teeth up to 2 teeth up to 2 teeth
up to 2 teeth up to 2 teeth up to 2 teeth up to 2 teeth
P10,000.00 P10,000.00 P10,000.00 P50,000.00

P20,000.00 P20,000.00 P20,000.00 P50,000.00
INTELLICARE
With Access
With Access
With Access
With Access
With Access
With Access
With Access
With Access
With Access
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Up to Php 20,000/member/year
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to P5,000/leg/member/year
Up to P1,000/member/year
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Covered
Up to 24 hours
Up to MBL
Up to 12 sessions/member/year
Up to MBL
Up to MBL
Up to Php 10,000 / member / year
Up to 12 sessions/member/year
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to 25,000/member/year
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Not Covered
Up to MBL
Up to 60K/member/year
Not Covered
Not Covered
Up to MBL
Not Covered
Up to MBL
Not Covered
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to MBL
Up to Maximum Benefit Limit

Up to 24 hours except Suite Room
Up to MBL via reimbursement based
Up to MBLonviathe HMO rates based
reimbursement
Up to MBLonviathe HMO rates based
reimbursement
on the HMO rates
Up to MBL
Up to P2,500 per conduction
Up to MBL (except cost of vaccines)
Up to 60,000/member year
Up to 60,000/member year
Up to MBL
Not Covered
Not Covered
Covered
Covered
Twice a year
Covered
Covered
Unlimited, As needed
up to 2 teeth
Covered
Covered
Covered
Covered
Covered
Covered
Covered
up to 2 teeth
P10,000.00
P20,000.00

Comparative Rates and Benefits

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Comparative Rates and Benefits

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MAXICARE

1 SMALL SUITE 350,000

2 OPEN PRIVATE 250,000

3 LARGE PRIVATE 200,000

1 SMALL SUITE 350,000

2 OPEN PRIVATE 250,000

3 LARGE PRIVATE 200,000

Maxicare Mplus best suits for companies with 10-19 employees.

34,815 SMALL SUITE 350,000 29,642

29,798 OPEN PRIVATE 250,000 25,281

28,199 LARGE PRIVATE 200,000 23,869

23,913 REGULAR PRIVATE 110,000 20,337

19,773 SEMI-PRIVATE 90,000 16,858

19,261 SEMI-PRIVATE 80,000 16,426

47,211 SMALL SUITE 350,000 40,057

39,987 OPEN PRIVATE 250,000 33,842

38,101 LARGE PRIVATE 200,000 32,258

32,819 REGULAR PRIVATE 110,000 27,818

26,361 SEMI-PRIVATE 90,000 22,391

25,848 SEMI-PRIVATE 80,000 21,961

578 Hospital 578

SUITE 4,000 400,000 28,583 SUITE 4,000

SUITE 3,000 400,000 26,309 SUITE 3,000

OPEN PRIVATE 250,000 22,428 OPEN PRIVATE

REGULAR PRIVATE 250,000 19,320 REGULAR PRIVATE

SEMI-PRIVATE 200,000 15,546 SEMI-PRIVATE

WARD 100,000 12,057 WARD

SUITE 4,000 400,000 38,237 SUITE 4,000

SUITE 3,000 400,000 35,426 SUITE 3,000

OPEN PRIVATE 250,000 29,753 OPEN PRIVATE

REGULAR PRIVATE 250,000 25,716 REGULAR PRIVATE

SEMI-PRIVATE 200,000 20,284 SEMI-PRIVATE

WARD 100,000 15,854 WARD

Hospital 619 Hospital

400,000 24,506 LARGE PRIVATE 100,000

400,000 22,591 REGULAR PRIVATE 100,000

250,000 19,180 REGULAR PRIVATE 75,000

250,000 16,649 SEMI-PRIVATE 75,000

200,000 13,452 SEMI-PRIVATE 60,000

100,000 10,372 WARD 50,000

400,000 32,615 LARGE PRIVATE 100,000

400,000 30,252 REGULAR PRIVATE 100,000

250,000 25,355 REGULAR PRIVATE 75,000

250,000 22,025 SEMI-PRIVATE 75,000

200,000 17,428 SEMI-PRIVATE 60,000

100,000 13,569 WARD 50,000

619 Hospital 450

16,854 LARGE PRIVATE 100,000 13,596

16,180 REGULAR PRIVATE 100,000 13,114

15,430 REGULAR PRIVATE 75,000 12,634

11,996 SEMI-PRIVATE 75,000 9,698

11,547 SEMI-PRIVATE 60,000 9,249

8,247 WARD 50,000 6,593

17,977 LARGE PRIVATE 100,000 19,893

16,572 REGULAR PRIVATE 100,000 18,300

15,822 REGULAR PRIVATE 75,000 17,551

11,678 SEMI-PRIVATE 75,000 12,910

11,229 SEMI-PRIVATE 60,000 12,461

7,689 WARD 50,000 8,545

450 Hospital 450

OPEN PRIVATE 150,000 15,330 SEMI-PRIVATE

REGULAR PRIVATE 100,000 11,700 SEMI-PRIVATE

SEMI-PRIVATE 80,000 9,570 WARD