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Maxicare Individual and Family Program
Maxicare Individual and Family Program
Maxicare Individual and Family Program
1. It is costly to get sick. With the high prices of medicines these days and the Professional fees of doctors
do not come cheap too; they range from P250 to P1,000 per visit. And if hospitalization is required, the bill
can run up to the millions for prolonged illnesses. It is not surprising, thus, for people to go broke over
medical bills. Lifetime savings may be wiped out after one prolonged hospital stay.
2. The government provides a health insurance to Filipinos through the Philippine Health Insurance Corp.
(Philhealth). Members can avail of coverage for medicines, hospitalization and doctor¢s fees according to
the schedules set by Philhealth. However, Philhealth coverage is not enough and covers to about 20-40%
of your hospital fees. Members have to turn to their savings to cover all health costs.
3. For an annual fee, HMOs can insure a person and cover preventive health care costs (check-ups,
laboratory fees) and hospitalization. The HMO has a list of accredited hospitals and health centers which
one can go to for health care. Should a person require further examination by a specialist, the HMO will
refer him to a physician accredited with them.
4. With HMOs you don’t need to shell out cash at the hospital or doctor¢s office. The HMO takes care of
all that as long as your account is current. There is no need to scrounge around for money in the event that
a deposit has to be made to the hospital prior to admission.
What your MAXICARE CARD can
do you for YOU?
Your MAXICARE card will give you free and
unlimited access to over 300 hospitals and clinics
nationwide. Simply present your card and avail of
your benefits.
HMO of Choice
And many other top & recognized hospitals in Luzon, Visayas & Mindanao
Extensive Customer Care Network
Corporate-Based
THE MAXICARE
INTELLIGENT CARD
Maxicare Swipe Card
• Real-time validation of membership during
availments
• Real-time record of availments which can
be viewed via the web
• Swipe facility using more than 600 POS
units of Equitable PCIBank nationwide
•Cards need not be replaced
on a yearly basis
MAXICARE TYPES OF
MEMBERSHIP
Type Size Age Eligibility Dependents Eligibility MEMBERSHIP FEES
Individual 1 applicant 2-60 years old, Not Applicable According to Plan of Choice, according to age
renewable up to 65
Family At least 2. Principal must be 18 to Dependent must follow Per Person, According to Plan of Choice, according to age
1 principal and 60 years old. hierarchy/order. If
at least 1 single, mother > father
dependent > eldest to youngest
sibling If married,
spouse > eldest child
>youngest child
Group 5-19 employees Employee must be 18 up At least 75% of the Per Person, According to Plan of Choice, according to age
to 60 years old employees must enroll
at least 1 dependent.
Must follow hierarchy
Corporate 20 employees & Employee must be 18 up to At least 75% of the Uniform Rates for all, Subject to a separate quotation.
up 65 years old employees must enrol at Rates on this presentation do not apply
least 1 dependent. Must
follow hierarchy
MAXICARE INDIVIDUAL &
FAMILY HEALTHCARE
PROGRAM
PLAN TYPE ROOM & BOARD MAXIMUM ANNUAL CHECK UP
BENEFIT LIMIT
B. NON-ACCREDITED HOSPITAL
• Maxicare shall reimburse 80% of the total hospital bills and 80% of the
professional fees up to Php 30,000.
Avail treatment at
Emergency Room
Proceed to Room
Notify MAXICARE
Within 24hrs.
4. Chronic Dermatoses:
Psorasis / Skin Asthma / Chronic Dermatoses
1. For new applicants whether the principal or dependent aged 50-60 yrs old, please
submit the following:
a) 12 Lead ECG / Electrocardiogram
b) Chest Xray
c) FBS / Fasting Blood Sugar
d) Total Cholesterol
e) HDL-C (High Density Lipoprotein)
f) LDL-C (Low Density Lipoprotein)