Saturday, April 12, 2014

Philippines HMO - ICARE

ICARE


Frequent ask question:

"Pare-pareho lang ang package 'nyo with other HMOs. Ano ang ipinagkaiba nyo sa kanila?"

"I-CARE has one of the best if not the best standard package in the industry. I-CARE also covers some conditions that are not covered by others.  There are also many HMOs who came and are gone.  This is where I-CARE has the most competitive edge in the industry - STABILITY. I-CARE is a subsidiary of the oldest and only mutualized Filipino life insurance company, INSULAR LIFE ASSURANCE COMPANY, which has been in the business for more than 99 years. Click here to find out why you should choose I-Care.


 "We are a group/company scouting for an HMO provider.  Why do you ask for a list of employees, nag-ca-canvass pa lang kami?

I-Care's corporate/group rates depend on the age profile of the group.  We have no standard rate for group accounts.  Hence the need for the list of employees.  The list being required does not have to contain the names of the employees.  The most important data is the date of birth or age of the employees.  All information you will submit will be strictly confidential.


What kind of "private " room does your Private Plan covers?

All our Private Room plan is "open type".  If for example you enrolled under Private, whatever kind of private room is available during you confinement, it will be your room accommodation. Kung P1,500 yung private room then it is going to be your room. Kung 3,000 so be it. However, in hospitals with different kinds and rate of private rooms, the "step-ladder" rule shall apply, where you have to start from the lowest available.


" Hindi na kailangan yan, meron na kaming PHILHEALTH."

This is one of the most common misconception about Philhealth. Philhealth benefits are limited, usually about 30% of your hospital bills. You will have to shoulder the 80% of the bill. And besides, PHILHEALTH has no outpatient benefits. Kung magpa-check-up ka, hindi covered ng PHILHEALTH, hospitalization lang ang covered nila. If you are a member of PHILHEALTH and have no means to pay big hospital bills you will have to settle with a government hospital sa ward section. With I CARE, pwede ka sa private room without having to pay for anything.


"Ano naman ang mangyayari sa Medicare/Philhealth ko?

I-CARE Corporate or Group Plan is integrated with PHILHEALTH and/or ECC.  Therefore, benefits under PHILHEALTH and/or ECC to which the member is entitled to shall be deducted from the claim cost in the computation of benefits under the program, unless otherwise agreed upon.  I-CARE shall pay all hospitalization bills in excess of PHILHEALTH benefits.  On the other hand, our Family/Individual is NOT integrated with benefits under PHILHEALTH or ECC.  If the member is entitled to such benefits, he/she should file for reimbursement directly with PHILHEALTH or ECC. Meaning, under Family/Individual, I-CARE will shoulder everything and it is up to the member to file for benefits claim with PHILHEALTH.


"Ano ba ang PEC o Pre-existing condition?"

Pre-existing condition or PEC is any illness that you may have during the time of your enrollment whether you are aware of it or not. Ito ay hindi covered during the first year of membership. However, it will be covered kung mag-re-renew ka sa susunod na year. The only condition is that you should declare/disclose it during your enrollment. Kung hindi mo i-declare, ma-de-deny ang availment mo for such illness.


"What if I don't get hospitalized within the year of my plan? Sayang lang ang ibinayad ko!"

Hindi ba mas mabuti yong hindi kayo naospital? That means you're healthy! And we wish to assure you that hindi sayang yong ibinayad ninyo. You see, this health care package covers cases which do not require hospitalization. Pati 'yung mga check-up covered rin. Kaya wala kang worry about paying for other fees, like CBC, urine test, and all other laboratory expenses.  Please click here to see our out-patient benefits.


 "Marami kami! Isang buong kumpanya. Meron ba kaming discount 'dyan?

Of course! Our group plan rates are very competitive and are lower than the regular rates. Also you can also have your dependents covered, asawa, anak, magulang, kapatid (Huwag lang kapitbahay). The more the merrier! Kung gusto mong group plan quotation click ka dito.. O kaya click ka dito to see our Group Plan page


Kung magpunta ako sa abroad, covered pa rin ba ako?

We do not have accredited hospitals abroad.


Puwede ba yung anak/baby ko lang ang e-enroll ko?

Kung meron ka nang HMO membership sa ibang HMO puwedeng mag-enroll yung anak mo lang. Pero kung wala ka pang HMO, kailangan both the parents should enroll para makapag-enroll din yung anak.


Pa'no yun kung kaming magkapatid gustong mag-enroll? Ako 27, s'ya ay 23.

No problem! Puwede kayong mag-enroll pareho both as principal


Puwede bang open yung hospital or doctor? Yun bang kahit saan ko gusto?

Under HMO practices, availments should be with an accredited hospital and accredited doctor. While you may go to any doctor or hospital you like, availments through them are not covered under the program


Marami kami. Isang buong angkan. Gusto namin i-waive 'nyo yung "Pre-existing condition".

Puwede yan. Pre-existing condition is covered after one year of membership.


Meron ba kayong maternity benefits?

Subject to special arrangements maternity benefits can be covered under "group plan" or "corporate" with at least 25 female employees.  However, pre-natal check-up and counseling is covered.


Kung mag-enroll ako ngayon at magbayad, covered ba ako agad?

Processing time is at least one week. Upon approval, you may start using your benefits. Under a corporate arrangement, effectivity is upon mutual agreement.


"O sige na nga, kumbinsido na 'ko. Ano ngayon ang gagawin ko?"

All you have to do is contact us at 782-22-20 or 0917-8192590 for details on how to enroll.  Or you may email us at sales@icare.net.ph


"What are the requirements kung mag-e-enroll?

You just have to fill up application form and summary of benefits.  YOU SHOULD DISCLOSE YOUR PRE-EXISTING CONDITION ON THE APPLICATION FORM. A MEDICAL CERTIFICATE STATING THE STATUS OF YOUR PRE-EXISTING CONDITION AND THE MEDICATION TREATMENT BEING DONE MAYBE REQUIRED.


"If my doctor is holding clinic in an accredited hospitals, but he is not an accredited doctor will I-Care cover consultations with him?

I-Care has a pool of doctors and specialists equally good as your doctor. In the first place if your doctor is not accredited, he will not honor your health card.



Contact :  Mr. Raul
0063 917 8192590  
0063 2 7822220
(office hours only Monday to Friday)







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