DESCRIPTION:

Product Highlights

• Up to ₱50,000 Emergency Coverage leading to confinement 

• Up to ₱50,000 Accidental Death Benefit

• Pre-existing conditions covered up to ₱50,000(excluding Cancer, Cholelithiasis, and their related conditions)*

• Regular private room & board

• Three (3) Maxicare Teleconsults

• Single usage per card. You can use multiple cards in a year

• Eligible for ages 15 days old to 65 years old only

• Valid for one (1) year from activation date

• No preliminary checkups and paperwork needed

• Nationwide access to Maxicare-affiliated hospitals excluding the six (6) major hospitals: Asian Hospital and Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center - Bonifacio Global City, St. Luke’s Medical Center - Quezon City, and The Medical City - Ortigas

• 15-day activation period after successful registration

*Subject to a 3-month waiting period.

Coverage

Coverage for life-threatening illnesses or injuries that need urgent medical care within 24 hours. This includes fractures from accidents, severe burns, allergic reactions, asthma attacks and more. If hospitalization is medically needed after an emergency, coverage includes confinement in a regular private room.

Includes

• Outpatient emergency coverage

• Doctor’s services for emergency treatment

• Emergency room fees

• Emergency medicines for immediate relief and treatment (no take-home medication)

• Oxygen, IV fluids, whole blood, and human blood products

• Dressings, casts, sutures

• X-ray, laboratory, and diagnostic exams

• Access up to 3 Maxicare 24/7 Teleconsults

Inpatient coverage

• Room and board accommodation in a regular private room

• Use of Operating Room, Intensive Care Unit (ICU), Isolation Room (if prescribed by the affiliated attending physician), and Recovery Room

• Professional fees

• Standard nursing services

• Medicines during confinement

• Whole blood products and IV fluids transmission

• X-ray, laboratory, and diagnostic exams

• Anesthesia, oxygen, and their administration

Exclusions and Limitations

• Non-Emergency Services

  • Services obtained for non-emergency conditions from Physicians and Providers

• Hospital and Medical Care Limitations

  • Additional charges for room upgrades and extended stays

  • Non-medical furnishings, appliances, personal items, extra food, and toiletries

  • Private or special nurse services

  • Custodial, domiciliary, convalescent, and intermediate care

  • Long-term rehabilitation

• Mental Health and Developmental Disorders

  • Psychiatric care and long-term rehabilitation

  • Developmental disorders (e.g., ADD/ADHD, Autism, Bipolar Disorders)

• Self-Inflicted Injuries and Risky Behaviors

  • Injuries from tattoos, body piercing, attempted suicide

  • Injuries resulting from negligence, drug/alcohol use, crime, law violations

  • Injuries from professional sports or hazardous activities

  • Injuries from riots, strikes, civil disturbances, or war

• Cosmetic and Elective Procedures

  • Aesthetic, cosmetic, and reconstructive surgery

  • Weight reduction programs and related procedures

  • Circumcision (except for urological conditions)

• Dental and Oral Health

  • Dental treatments and oral surgery (except for accidental injury)

• Reproductive Health

  • Maternity care and pregnancy-related conditions

  • Fertility/infertility treatments, sterilization, sex transformation

• Experimental and Alternative Treatments

  • Experimental medical procedures

  • Alternative medicine (e.g., acupuncture, chirotherapy)

• Organ Donation

  • Expenses for the member as an organ donor

• Routine and Preventive Care

  • Routine physical examinations for employment, school, insurance, travel, etc.

  • Vaccines and immunizations (including administration)

• Medical Equipment and Supplies

  • Purchase or lease of durable medical equipment (except during covered inpatient care)

  • Corrective appliances, prosthetics, and orthotics

  • Take-home and outpatient medicines (with some exceptions)

• Pre-Existing Conditions

  • Cancer and its related conditions

  • Cholelithiasis and its related conditions

• Infectious Diseases

  • Sexually transmitted diseases, HIV, and AIDS

  • Infectious diseases declared as epidemics or pandemics

  • Hepatitis B and related screenings/vaccines

• Specific Treatments and Procedures

  • Speech therapy for developmental and congenital diseases

  • Intravenous Immunoglobulin (IVIG)

  • Scoliosis treatments (except during emergency care)

• Financial Limitations

  • Costs exceeding the Annual Benefit Limit (ABL)

  • Medico-legal case costs