HEALTHCARE PROGRAM FOR

PREPAID PRODUCTS

All rights reserved. No part of this presentation may be reproduced or used for any other purpose without the consent of Maxicare’s Marketing Division.

Why

We are No.1 HMO in

the Philippines

32 Years of solid

healthcare expertise.

With more than 1.5

Million cardholders

nationwide.

?

We have the most numbered of

ACCREDITED Hospitals & Clinics

NATIONWIDE

HMO Prepaid Products

WHAT IS A PREPAID CARD?

• Non-transferrable

• One time use only

• With validity period

EREADY

A prepaid health card that provides one-time coverage for

emergency related cases only in all Maxicare affiliated

hospitals nationwide

EREADY

TITANIUM

Php 699.00

PLATINUM

Php 899.00

Platinum - Php 899 Titanium – Php 699

Access to all 1,500 + accredited hospitals including 6 Major hospital in Metro Manila

Asian Hospital Cardinal Santos Medical Center Makati Medical Center St. Lukes sa Quezon City St. Lukes sa BGC Taguig The Medical City

EREADY

Access to all 1,500 + accredited hospitals excluding 6 Major hospital in Metro Manila

Asian Hospital Cardinal Santos Medical Center Makati Medical Center St. Lukes sa Quezon City St. Lukes sa BGC Taguig The Medical City

BENEFITS & COVERAGE:

Provides up to Php 15,000 one – time coverage on

illnesses or injuries that arises from medical-related

emergency conditions

Outpatient emergency coverage

includes:

• Doctor’s services for emergency

treatment

• Emergency room fees

• Medicines used for immediate relief

and during treatment

• Oxygen, IV fluids, whole blood and

human blood products

• Dressings, casts, sutures 6. X-ray,

laboratory and diagnostics exams

PRE-EXISTING CONDITION

Heart Condition High blood

Diabetes

Asthma Heat Stroke

Allergy

Animal Bites

SAMPLE

EMERGENCY CASES

SAMPLE

ACCIDENTS

BENEFITS & COVERAGE:

Membership Eligibility: 15 days old - 65 years old

Other Inclusions:

• Group Life with ADD&D (Accidental Death, Dismemberment &

Disablement) of up to P 50,000 – P100,000

• 10% discount on Metro Dental services (www.metrodental.com.ph)

• Access to Maxicare TeleConsult 24/7 service.

• 15% discount on MyHealth Clinic Services (www.myhealth.com.ph)

ADDITIONAL DETAILS:

• Card Activation is 7 days after a successful registration.

• The coverage period/validity is One (1) year from the

ACTIVATION date

• If the member coverage has already expired but with NO

Availment, the member may register another card on the

next day after expiration of coverage.

• Member is entitled to register only ONE ACTIVE CARD AT

A TIME.

• Member may register another card after Three (3) months

from the date of availment of the First registered card.

• Member can register Online (www.maxicare.com.ph)

• Services obtained for emergency conditions from non-

affiliated Physicians and Hospitals

• Injuries, infections or conditions resulting from:

NEGLIGENCE

ALCOHOLIC LIQUOR INTAKE

UNAUTHORIZED USE OF PROHIBITED DRUGS

VIOLATION OF LAW OR ORDINANCE OR

UNNECESSARY EXPOSURE TO IMMINENT

DANGER

DIRECT OR INDIRECT PARTICIPATION IN THE

COMMISSION OF CRIME

DIRECT PARTICIPATION IN RIOTS, STRIKES AND

OTHER CIVIL DISTURBANCES

DEVELOPMENTAL DISORDERS

EXCLUSIONS & LIMITATIONS:

WAR OR ANY COMBAT-RELATED ACTIVITIES WHILE

IN MILITARY SERVICE

EXTREME SPORTS

CIRCUMCISION

SEX TRANSFORMATION

TATTOOS & BODY PIERCING

ACUPUNCTURE

CONGENITAL, GENETIC OR HEREDITARY

CONDITIONS

CHRONIC DERMATOSES

ORAL SURGERY OR DENTAL TREATMENTS

ALL TYPES OF VACCINES EXCEPT FOR ANIMAL

BITES

ANY PREGNANCY RELATED CONDITIONS

MYMAXICARE LITE

A prepaid health card that provides one-time In-Patient

benefit and covers eight (8) illnesses: Dengue, Malaria,

Cholera, Typhoid and Paratyphoid, Gastroenteritis,

Pneumonia, Leptospirosis and Chikungunya.

MYMAXICARE LITE

MYMAXICARE LITE

BLUE

Php 1,999.00

MYMAXICARE LITE

YELLOW

Php 2,499.00

Yellow -Php 2499 Blue - Php 1999

MYMAXICARE LITE

Access to all 1,500 + accredited

hospitals excluding 6 Major

hospital in Metro Manila Asian Hospital

Cardinal Santos Medical Center

Makati Medical Center

St. Lukes sa Quezon City

St. Lukes sa BGC Taguig

The Medical City

Access to all 1,500 + accredited

hospitals including 6 Major

hospital in Metro Manila Asian Hospital

Cardinal Santos Medical Center

Makati Medical Center

St. Lukes sa Quezon City

St. Lukes sa BGC Taguig

The Medical City

BENEFITS & COVERAGE:

Provides up to Php 25,000 one – time confinement

benefit that only covers specific illnesses: Inpatient coverage includes:

• Room and board accommodation in a

regular private room

• Use of Operating Room, Intensive Care

Unit (ICU), Isolation Room (if

prescribed by the attending accredited

physician) and Recovery Room

• Professional fees

• Standard nursing services 5. Medicines

when in confinement

• Whole blood products, and IV fluids

transfusion

• X-ray, laboratory tests and diagnostic

tests 8. Anesthesia, oxygen and its

administration

8 ILLNESSES COVERED

Dengue

Cholera

Pneumonia

Typhoid

Malaria

Gastroenteritis

Chikungunya

Leptospirosis

BENEFITS & COVERAGE:

Membership Eligibility: 2 years old - 65 years old

Other Inclusions:

• 10% discount on selected Metro Dental services

(www.metrodental.com.ph)

• Access to Maxicare TeleConsult 24/7 service.

• 15% discount on MyHealth Clinic Services (www.myhealth.com.ph)

ADDITIONAL DETAILS:

• Card Activation is 15 days after a successful registration.

• The coverage period/validity is One (1) year from the

ACTIVATION date

• If the member coverage has already expired but with NO

Availment, the member may register another card on the

next day after expiration of coverage.

• Member is entitled to register only ONE ACTIVE CARD.

• Member can register Online (www.maxicare.com.ph)

EREADY ADVANCE

A prepaid health card that provides one-time coverage for

emergency related cases including those requiring

confinement in all Maxicare affiliated hospitals nationwide.

It also covers free and unlimited consultations in all

Maxicare Primary Care Centers

EREADY ADVANCE

E-ADVANCE TITANIUM

Php 2,950.00

E-ADVANCE PLATINUM

Php 3,950.00

Platinum – Php 3,950 Titanium – Php 2,950

Access to all 1,500 + accredited hospitals including 6 Major hospital in Metro Manila

Asian Hospital Cardinal Santos Medical Center Makati Medical Center St. Lukes sa Quezon City St. Lukes sa BGC Taguig The Medical City

EREADY ADVANCE

Access to all 1,500 + accredited hospitals excluding 6 Major hospital in Metro Manila

Asian Hospital Cardinal Santos Medical Center Makati Medical Center St. Lukes sa Quezon City St. Lukes sa BGC Taguig The Medical City

Provides up to Php 50,000 one – time coverage on

illnesses or injuries that arises from medical-related

emergency conditions including those requiring

confinement in a Regular private room.

BENEFITS & COVERAGE:

BENEFITS & COVERAGE:

Outpatient emergency coverage

includes:

• Doctor’s services for emergency

treatment

• Emergency room fees

• Medicines used for immediate

relief and during treatment

• Oxygen, IV fluids, whole blood

and human blood products

• Dressings, casts, sutures 6. X-

ray, laboratory and diagnostics

exams

Inpatient coverage includes:

• Room and board accommodation in

a regular private room

• Use of Operating Room, Intensive

Care Unit (ICU), Isolation Room (if

prescribed by the attending

accredited physician) and Recovery

Room

• Professional fees

• Standard nursing services 5.

Medicines when in confinement

• Whole blood products, and IV fluids

transfusion

• X-ray, laboratory tests and diagnostic

tests 8. Anesthesia, oxygen and its

administration

Consultation:

Cardholders may also enjoy free and

unlimited consultation in all Maxicare

Primary Care Centers (PCCs) nationwide.

BENEFITS & COVERAGE:

Membership Eligibility: 15 days old - 65 years old

Other Inclusions:

• Group Life with ADD&D (Accidental Death, Dismemberment &

Disablement) of up to P 50,000 – P100,000

• Emergency medical evacuation for members who are more than

150 km away from place of residence.

• 10% discount on Metro Dental services (www.metrodental.com.ph)

• 15% discount on MyHealth Clinic Services (www.myhealth.com.ph)

• Access to Maxicare TeleConsult 24/7 service and Maxicare HealthHub.

• Pre-Existing Conditions are covered

ADDITIONAL DETAILS:

• Card Activation is 7 days after a successful registration.

• The coverage period/validity is One (1) year from the

ACTIVATION date

• If the member coverage has already expired but with NO

Availment, the member may register another card on the

next day after expiration of coverage.

• Member is entitled to register only ONE ACTIVE CARD

AT A TIME.

• Member may register another card after Seven (7) days

from the date of availment of the First registered card.

• Member can register Online (www.maxicare.com.ph)

• Services obtained for emergency conditions from non-

affiliated Physicians and Hospitals

• Injuries, infections or conditions resulting from:

NEGLIGENCE

ALCOHLIC LIQUOR INTAKE

UNAUTHORIZED USE OF PROHIBITED DRUGS

VIOLATION OF LAW OR ORDINANCE OR

UNNECESSARY EXPOSURE TO IMMINENT

DANGER

DIRECT OR INDIRECT PARTICIPATION IN THE

COMMISSION OF CRIME

DIRECT PARTICIPATION IN RIOTS, STRIKES AND

OTHER CIVIL DISTURBANCES

DEVELOPMENTAL DISORDERS

EXCLUSIONS & LIMITATIONS:

WAR OR ANY COMBAT-RELATED ACTIVITIES

WHILE IN MILITARY SERVICE

EXTREME SPORTS

CIRCUMCISION

SEX TRANSFORMATION

TATTOOS & BODY PIERCING

ACUPUNCTURE

CONGENITAL, GENETIC OR HEREDITARY

CONDITIONS

CHRONIC DERMATOSES

ORAL SURGERY OR DENTAL TREATMENTS

ALL TYPES OF VACCINES EXCEPT FOR ANIMAL

BITES

ANY PREGNANCY RELATED CONDITIONS

AMBULANCE SERVICE IF WITHIN 150 KM

PRIMA

An HMO program for individuals which offers unlimited

outpatient Consultations, and availment of Laboratory

and Diagnostic Procedures within Maxicare’s network of

Primary Care Centers (PCC) and MyHealth Clinics

Features PRIMA SILVER PRIMA GOLD

Cost P4,999 (one-time payment) P12,999 (one-time payment)

Age Eligibility 0 – 59 years old 60 years old and above

Benefits • Unlimited consultations and

outpatient laboratory to all

Maxicare Primary Care

Centers only

• Pre-existing conditions are

covered

• Dental Coverage to all Metro

Dental Clinics

• Maternity Coverage

• Unlimited consultations and

outpatient laboratory to all

Maxicare Primary Care

Centers and MyHealth

Clinics

• Pre-existing conditions are

covered

• Dental Coverage to all Metro

Dental Clinics • With a consumable Php 20,000

annual emergency room

coverage at all Maxicare

affiliated hospitals nationwide

LIST OF MYHEALTH CLINICS: (for GOLD MEMBERS only)

• MyHealth Clinic – Edsa Shangrila

• MyHealth Clinic – Robinson Place Manila

• MyHealth Clinic – Festival Mall Alabang

• MyHealth Clinic – SM North Edsa

• MyHealth Clinic – Venice Grand Canal Mall, Taguig City

• MyHealth Clinic - Cebu Cybergate and Robinsons Galleria Cebu

PRIMA MEMBERS Exclusive Access

(with laboratory and consultation)

LIST OF MAXICARE STAND ALONE PRIMARY CARE CENTERS (PCC):

• MAXICARE PCC – BONIFACIO GLOBAL CITY (BGC) 24/7

• MAXICARE PCC – BRIDGETOWN IT PARK 24/7

• MAXICARE PCC – CLARK PAMPANGA (mall hours)

• MAXICARE PCC – CEBU BUSINESS PARK AYALA 24/7

• MAXICARE PCC – AYALA NORTH EXCHANGE 24/7

• MAXICARE PCC – CENTRIS QUEZON AVE – AUG 2020

• MAXICARE PCC – NORTHGATE ALABANG – AUG 2020

• MAXICARE PCC – DOUBLE DRAGON PLAZA – SEPT 2020

• MAXICARE PCC – ILOILO

• MAXICARE PCC – DAVAO

STAND ALONE CLINICS

MyHealth clinic is a Maxicare-affiliated clinic located at selected malls in Metro Manila, making them easily accessible.

• SM North EDSA

2nd Level, North EDSA, Quezon City

• EDSA Shangri-La

Level 1, Shangri-La Plaza Shaw Blvd.,

Mandaluyong City

• Festival Supermall

Level 2, Festival Supermall Filinvest, Alabang

• Robinsons Cybergate, Cebu

3rd Level, Robinsons Cybergate Fuente Osmena,

Cebu City

• Venice Grand Canal, McKinley

2nd Level, Venice Grand Canal, McKinley Hill

Garden Villas,Upper McKinley Rd, Taguig City

• Robinsons Place Manila

3rd Floor Mezzanine, Pedro Gil Wing Robinsons

Place, Ermita, Manila

PRIMA MEMBERS Exclusive Access

(for consultations only)

LIST OF PRIMARY CARE CENTERS (clinics inside the hospitals )

• MAXICARE PCC – CARDINAL SANTOS MEDICAL CENTER

• MAXICARE PCC – CENTURIA MEDICAL MAKATI

• MAXICARE PCC – CHINESE GENERAL HOSPITAL

• MAXICARE PCC – MAKATI MEDICAL CENTER

• MAXICARE PCC – ST. LUKES MEDICAL CENTER QC

• MAXICARE PCC – ST. LUKES MEDICAL CENTER BGC

• MAXICARE PCC – THE MEDICAL CITY

3rd Floor, Tower 1

Makati Medical Center

Room 160, Ground Floor Medical Arts Bldg. Cardinal

Santos Medical Center, Wilson St. Greenhills, San Juan City

Unit 933, Centuria Medical

Makati Centuria City, Kalayaan

Ave. Cor. Salamanca St. Brgy. Poblacion Makati City

10th Floor Medical Arts Bldg., Chinese General Hospital

Sta. Cruz Manila

Room 325, Medical Arts Building

St. Lukes, Fort Bonifacio, Global City

15th Floor, North Tower

St. Lukes, Quezon City

Ground Floor Medical Arts Bldg.,

Medical City, Ortigas Avenue,

Pasig City

PRODUCT VARIANT

PRIMA Silver

PRIMA Gold

Consultation Primary Care Centers

(PCC)

Primary Care Centers (PCC)

and MyHealth Clinics

OP Labs and

Procedures

PCC BGC, PCC

Bridgetowne IT Park, PCC

Cebu and PCC SM Clark

PCC BGC, PCC Bridgetowne

IT Park, PCC Cebu, PCC SM

Clark and MyHealth Clinics

Emergency

Coverage NONE

Any affiliated hospitals

including major hospitals

Dental Metro Dental Metro Dental

UNLIMITED OUTPATIENT CONSULTATIONS WITH ANY

OF THE FF DOCTORS:

LOCATION

STAND ALONE

Maxicare Primary Care

Centers

Other Maxicare

Primary Care

Centers

MyHealth Clinics

DOCTORS

• Internal Medicine (IM)

• Ear-Nose – Throat

(ENT)

• Obstetrician -

gynecologist (OB-

GYN)

• Dermatologist

Internal Medicine

(IM) only

• Internal Medicine

(IM)

• Ear-Nose – Throat

(ENT)

• Obstetrician -

gynecologist (OB-

GYN)

• Dermatologist

• Ophthalmologist

• Maternity Procedures (FOR SILVER MEMBER only)

1st Trimester

Transvaginal Ultrasound

Complete Blood Count (CBC)

Routine Urinalysis

Blood Typing ABO and RH

HIV Test

HBsAG

VDRL or RPR

Fasting Blood Sugar (FBS)

Rubella Igm

Rubella IgG

2nd Trimester

Congenital Anomaly Scan

OGTT

3rd Trimester

Bio Physical Scoring

Complete Blood Count

**Assumption: Normal Pregnancy; no complications

• Covered Laboratory and Diagnostic Procedure

ABO and Rh

AFB stain

Albumin

Alkaline

Phosphatase (ALP)

ALT (SGPT)

Amphetamine

Amylase

AST (SGOT)

Barbiturates

Benzodiazepines

Bilirubin – Direct

Bilirubin – Group

Bilirubin – Total

Calcium

Cannabinoids

Chloride

Cholesterol

Cocaine

Complete Blood

Count

Creatinine (with

EGFR)

Ecstacy

Fecalysis

FT3

FT4

GGT

Glucose

HbA1c (with

eAG)

HDL Cholesterol

Hepatitis A IgM

Hepatitis B

Envelope Ab

Hepatitis B

Envelope Ag

Hepatitis B Surface

Ab

Hepatitis B Surface

Ag

Hepatitis C Ab

HIV Ag/Ab 1&2

LDH

LDL Cholesterol

Lipase

Lipid Studies

Magnesium

Micral Test

Non-Fasting Lipid

Profile

Opiates

Pap smear

Phencyclidine

(PCP)

Phosphorus

Potassium

PSA – Total

PT (INR)

PTT (APTT)

Sodium

Syphilis Ab

T3

T4

Total Protein

Triglycerides

TSH

Urea

Uric Acid

Urinalysis

• ULTRASOUND PROCEDURES WITH PREPARATION:

WHOLE ABDOMEN – 8-10HRS FASTING, FULL BLADDER

UPPER ABDOMEN – 8-10 HRS FASTING

HEPATOBILIARY TREE – 6-8 FASTING

HEPATOBILIARY TREE, PANCREAS (HBT-P) – FASTING 6-8 HRS

LOWER ABDOMEN – FULL BLADDER

KIDNEYS, URETERS, BLADDER (KUB) – FULL BLADDE

• ULTRASOUND PROCEDURES WITHOUT PREPARATION:

THYROID

LIVER

KIDNEYS

BREASTS

APPENDIX

PROSTATE

UTERUS

• COVERED X-RAY

SKULL

PARANASAL SINUSES

MANDIBLE

CERVICAL SPINE

THORACIC SPINE

LUMBAR SPINE

SACRUM

COCCYX

CHEST

FINGERS

ABDOMEN

PELVIS

HIP JOINT

FEMUR/UPPER LEG

KNEE JOINT

TIBIA & FIBULA/LOWER LEG

ANKLE

FOOT

SHOULDER

SCAPULA

CLAVICLE

HUMERUS/

UPPER ARM

ELBOW

FOREARM

WRIST

HAND

• ULTRASOUND PROCEDURES BY APPOINTMENT

NECK

INGUINAL/SCROTAL

RECTAL

Other tests:

• ECG available in all PCC’s w/ Labs and MyHealth Clinics

• 2D ECHO available available only in Ayala NorthExchange, Bridgetowne, Clark and Cebu

• TREADMILL STRESS TEST available only in Ayala NorthExchange, Bridgetowne, Clark and Cebu

6/28/2020 50

FREE Dental Care Services with

MetroDental.

Avail of the following services once

within one (1) year:

• Mild Oral Prophylaxis (Cleaning)

• Panoramic X-Ray (Full Mouth)

• Dental Consult

• Emergency relief of dental pain

through medication

• Cosmetic or oral rehab treatment

planning

• Dental nutrition and counseling

• Dental health education

• Preparation of dental certificates

• Safekeeping of dental records as

required by law or client