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)







Monday, August 26, 2013

Philippines HMO - Intellicare


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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Philippines HMO - Medicard


MEDICARD



If you’re looking for HMO without age limit this is the best Healthcare Card for you. Medicard introduce the RxER which has low annual fee, no age limit and no medical check-up required.

Also you can enjoy the Members can enjoy unlimited free consultations with primary care physicians and some specialists like pediatricians, medical internists and OB Gynecologists. Outpatient services are availed in all MediCard free standing clinics and UROIC.

Membership is only P1,998.00 each and is open to individuals or to groups who will enjoy no provisions for hierarchy, status and family relationships. This membership is already good for one year. 

MediCard Clinics

MediCard Makati Clinic
G/F King's Court Bldg., Chino Roces Avenue, Makati City
Tel. No: 511-8364 to 66
Contact Person: Ms. Bing Olivar
Clinic Hours: M-F 7am -6pm
Sat 7am - 3pm

MediCard Quezon City Clinic
Unit E, F, G Two Cyberpod Centris, ETON Centris EDSA Corner Quezon Ave., Q.C.
Contact No: 775-4629/920-5164/920-8457
Contact Person: Ms. Lyma Villaruel
Clinic Hours: M-F 7am - 7pm
Sat 7am - 5pm

MediCard Sta. Rosa Clinic
Sta.Rosa-Tagaytay National Road (facing Paseo de Sta. Rosa), Laguna
Tel. No: 584-4048 (manila line); (049) 544-0634 to 35;
(049) 544-0638; (049) 544-0648
Contact Person: Ms. Grace Montero
Clinic Hours: M-F 7am - 7pm
Sat 7am - 5pm

MediCard Alabang Clinic
3/F Festival Supermall, Filinvest Corporate City, Alabang, Muntinlupa City
Tel. No: 850-1146; 850-3209
Contact Person: Ms. Marisciel Santisteban
Clinic Hours: M-S 8am - 9pm

MediCard Cavite Clinic
G/F Metrobank Bldg., Aguinaldo Highway, Anabu ll, Imus, Cavite
Tel. No: (046) 472-1800
Contact Person: Ms. Jenema Dupa
Clinic Hours: M-F 7am - 7pm
Sat 7am - 4pm

MediCard Calamba Clinic
2F Star Honda Bldg., Brgy. Parian, National Highway, Calamba Laguna
Tel. No: 584-4288; (49) 502-6300
Contact Person: Ms. Mary jane Fallesgon
Clinic Hours: M-F 7am- 7pm
Sat. 7am- 3pm

MediCard - Cebu City
G/F JRDC Bldg. Pres. Osmeña Blvd. Capitol Site, Cebu City
Tel. No: (032) 253-5031; (032) 256-6463; (032) 253-1725
Contact Person: Ms. Leonita Valdez
Clinic Hour: M-F 7 am- 7 pm
Sat: 7 am - 3 pm

MediCard Fairview Clinic
27- C Fairview Ave., Fairview, Quezon City
Tel. No: 935-0949; 935-7579
Contact Person: Ms. Jinima San Valentin
Clinic Hour: M-F 7 am- 7 pm
Sat: 7 am - 4 pm

MediCard Ortigas Clinic
Unit 105 Parc Royale Condominium, Julia Vargas Ave., Ortigas Center, Pasig City
Tel. No: 638-0595; 638-3207
Contact Person: Relee Cepeda
Clinic Hours: M-F 7am - 7pm
Sat 7am - 5pm




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