Under Intellicare’s HMO Program, corporate clients
gain access to Intellicare’s nationwide network of medical providers based on a
fixed and periodic payment agreed upon by both companies. Clients under the HMO
Program have dedicated Account Officers who handle all queries and concerns
raised by the members, as well as Wellness Programs catered to their current
health-related needs and wants.
Who is eligible to enroll?
- Single
Proprietor/Partnership/Corporation duly registered with DTI or SEC to
conduct business in the Philippines.
- Minimum of 10 regular
employees.
Membership Eligibility
1.
Principal
members – eligible employees (as determined by the enrolling company) aged 18
and not more than 65 years old
2.
Dependents:
a.
For
married principals:
§ Legal spouse, not
more than 65 years old
§ Children –
legitimate, legally adopted or legitimated; unmarried, unemployed, wholly
dependent financially on the Principal member; not more than 21 years old
b.
For
single/unmarried principals:
§ Biological children –
unmarried, unemployed, not more than 21 years old
§ Parents – not more
than 65 years old
§ Siblings – unmarried,
unemployed, wholly dependent financially on the Principal member; not more than
21 years old
What are the benefits in
enrolling under the HMO Program?
- Intellicare members have the
privilege to avail of the following services at any accredited hospitals
and clinics nationwide.
A.
ANNUAL
PHYSICAL EXAM
§ Complete blood count
§ Physical examination
§ Urinalysis
§ Fecalysis
§ Chest x-ray
§ Electrocardiogram
(for members age thirty-five (35) years and above, or if indicated/prescribed)
§ Pap smear (for female
members age thirty-five (35) years and above, or if indicated/prescribed)
B.
PREVENTIVE
CARE
§ Periodic medical
check-up
§ Management of health
problems
§ Counseling on health
habits (e.g. family planning, diet prescriptions)
§ Record keeping of
medical history
§ Routine Immunization
(except cost of vaccines)
C.
OUT-PATIENT
§ Medical consultation
during regular clinic hours, excluding prescribed medicines
§ Emergency room care
§ Referral to
affiliated specialist/s
§ Eye, ear, nose, and
throat consultations
§ Treatment of minor
injuries and/or illnesses
§ Laboratory tests,
x-rays, and other diagnostic exams prescribed by the Intellicare physician
§ Minor surgery not
requiring confinement
§ Speech and physical
therapy
§ Pre-natal and
post-natal consultations
D.
IN-PATIENT
CONFINEMENT
§ No deposit upon
admission
§ Room and board
benefits specified in contract
§ Use of operating room
and recovery room facilities
§ Standard admission
kit (e.g. ID bracelet, thermometer)
§ Professional services
of all attending affiliated specialists and/or anesthesiologists
§ Anesthesia and
medications
§ Blood transfusions
and intravenous fluids
§ Laboratory tests,
x-rays, and other diagnostic examinations
§ Administered
medicines
§ Dressings, plaster
casts, sutures, and other items directly related to the medical management of
the patient
§ ICU
confinement/dialysis
§ CT scan and
ultrasound (except for maternity cases)
§ Ambulance service
§ All other hospital
charges deemed necessary by the Intellicare-affiliated physician in the
treatment of the patient
E.
EMERGENCY
CARE
1. IN ACCREDITED
HOSPITALS
§ Doctor’s services
§ Medicines used
§ Oxygen and
intravenous fluids
§ Dressings, casts, and
sutures
§ Laboratory, x-ray,
and other diagnostic examinations directly related to the emergency management
of the patient
2. IN NON-ACCREDITED
HOSPITALS
§ Intellicare agrees to
reimburse up to eighty percent (80%) of the total hospital bills including professional fees using the
Intellicare Relative Values Scale (RVS) but not to exceed Php 30,000.00.
3. IN FOREIGN COUNTRIES
§ Confinement in
foreign territory shall be treated as if the member had been confined in a
non-accredited hospital facility using the Intellicare Relative Values Scale
(RVS) but not to exceed Php 30,000.00.
4. IN AREAS WITHOUT
ACCREDITED HOSPITALS
§ Intellicare agrees to
reimburse up to one hundred percent (100%) of the total hospital bills
including professional fees using the Intellicare Relative Values Scale (RVS)
but not to exceed Php 30,000.00.
F.
FINANCIAL
ASSISTANCE INCLUDING ACCIDENTIAL DEATH AND DISMEMBERMENT (for principal members
only)
§
♦ Natural
death
|
Php 10,000.00
|
♦ Accidental
death
|
Php 20,000.00
|
♦ Loss
of both hands
|
Php 10,000.00
|
♦ Loss
of both feet
|
Php 10,000.00
|
♦ Loss
of sight of both eyes
|
Php 10,000.00
|
♦ Loss
of one hand and one foot
|
Php 10,000.00
|
♦ Loss
of one hand and sight of one eye
|
Php 10,000.00
|
♦ Loss
of one foot and sight of one eye
|
Php 10,000.00
|
♦ Loss
of one hand or one foot
|
Php 5,000.00
|
♦ Loss
of sight of one eye
|
Php 5,000.00
|
G.
OPTIONAL
BENEFIT (Dental Services)
§ Dental examination
§ Annual oral
prophylaxis
§ Oral health education
through chairside instruction
§ Orthodontic
consultation (braces and malposition of teeth)
§ Pre-natal check of
teeth and gums
§ Temporo Mandibular
Joint (TMJ) consultation (clicking of jaws)
§ Conduct activities on
dental health education (e.g. regarding AIDS)
§ Emergency dental
treatment for the relief of pain
§ Gum treatment for
cases like inflammation or bleeding
§ Temporary fillings
§ Simple extraction of
unsavable tooth
§ Recementation of
fixed bridges, crowns, jackets, inlays/outlays
How can we get a quotation and
enroll in the HMO Program?
- As of the moment,
Intellicare only accepts requests for proposals for CORPORATE ACCOUNTS.
Should you wish have Intellicare as your healthcare provider, click HERE
Intellicare Office
FELIZA OFFICE
Address and Contact Number
7th Floor, Feliza Building,
108 V.A. Rufino Street (formerly Herrera Street),
Legaspi Village, Makati City, Philippines 1229
Contact number: (02) 789-4000
SKYLAND OFFICE
Address and Contact Number
2nd Floor, Skyland Plaza Condominium,
Senator Gil Puyat Avenue corner Tindalo Street, San
Antonio Village,
Makati City, Philippines 1203
Contact number: (02) 902-3400
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