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.

HEALTHCARE PROGRAMFOR

Vmware Philippines Inc.

Coverage Period: December 1, 2020 to November 30, 2021

MAXICARE IS A COMPANY COMMITTED TO CONTINUOUS

PROGRESS FOR ITS CLIENTS

Maxicare Multifunction Card (MMC)

Equipped with the latest EMV (Europay, Master Card, and Visa) chip technology

These are Maxicare-owned healthcare facilities / clinics that have its own staff of customer service representatives and primary care physicians, who

administer healthcare assistance to Maxicare members only.

*Available in BGC & Bridgetowne

● Exclusive to Maxicare Members Only● Top notch Physicians● Unlimited number of FREE

consultations● Easier retrieval and a more secure

storage of your medical history with our Electronic Medical Records

● Up to 255 laboratory & diagnostic procedures*

Room 325, Medical Arts BuildingSt. Lukes, Fort Bonifacio, Global City

15th Floor, North TowerSt. Lukes, Quezon City

Ground Floor Medical Arts Bldg.,Medical City, Ortigas Avenue,

Pasig City

10th Floor Medical Arts Bldg.,Chinese General Hospital

Sta. Cruz Manila

3rd Floor, Tower 1Makati Medical Center

Unit 933, Centuria Medical Makati Centuria City, Kalayaan Ave. Cor. Salamanca St. Brgy.

Poblacion Makati City

Room 160, Ground Floor Medical Arts Bldg. Cardinal

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

The most relaxing healthcare experience

An average of only 6 mins wait timeTop notch doctors State - of - the - art facilities for laboratory and diagnostic proceduresAmenities for your convenience: beverage bar, free WIFI & charging stationsPaperless transactions and Electronic Medical RecordsUp to 255 laboratory & diagnostic procedures

Multi-Specialty:Internal MedicineFamily Medicine/Occupational HealthPediatricsENTOb-Gynecology

Services:TeleMedicineECG /2D Echo Treadmill Stress TestDiagnostics LaboratoryDiagnostics ImagingUltrasoundX-Ray (Plain)

SCHEDULE AN APPOINTMENT IN OUR PRIMARY CARE CENTERS

Our clinic staff will confirm your appointment by email or SMS within 24 hours.

Call or email your preferred PCC any day between 7am to 7pm.

For screening purposes, our clinic will require you to accomplish the health declaration form which will be sent via email along with your clinic appointment slip. For SMS recipients, the health declaration form may be accomplished on the day of your visit

On the day of your visit, please bring a print out of the health declaration form and Clinic Appointment Slip or you may show the soft copy to our clinic staff. For SMS recipients, you may show the SMS confirmation to our clinic staff.

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

*Clinic hours are subject to mall hours

• SM North EDSA2nd Level, North EDSA, Quezon City

• EDSA Shangri-La Level 1, Shangri-La Plaza Shaw Blvd., Mandaluyong City

• Festival SupermallLevel 2, Festival SupermallFilinvest, Alabang

• Robinsons Cybergate, Cebu3rd Level, Robinsons CybergateFuente Osmena, Cebu City

• Venice Grand Canal, McKinley2nd 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

• Availability beyond 5PM and during weekends*

• FREE consultation with Maxicare’s Special Consulting Physician (SCP)

• Access to state-of-the-art medical facilities

• Easy access because they can be found in malls

is a portal on the website dedicated for Maxicare members. The member gateway aims to provide full access from one’s basic information to online LOA requests.*c

• Member information• Transaction Summary• Online LOA • Online reimbursement

Convenience. No need to leave the comforts of your home or take a leave from work for a doctor’s consultation.

Savings. Zero charges on your Benefit Limit.

Reliability. A Maxicare - affiliated Physician will attend to your medical concern.

(02) 8582-19-80

Maxicare Telemedicine service is now available in Metro Manila and will soon be launched nationwide

Exclusive for members, they can have access to our new generation Primary Care Centers

and have a session with our available mental health specialists.

Bridgetown2nd flr. Zeta Tower, Bridgetowne IT Park, Brgy. Ugong Norte, Quezon CityLandline: (02) (8) 908-6959

W City Center7th Ave. cor 30th St., Bonifacio Global City, TaguigLandline: (02) (8) 908-6957

Salient Features

STATUS OF EMPLOYEE ALLOWED DEPENDENT/S AGE RQMT OF DEPENDENT/S

MarriedSpouse Up to 65 years old

Children 15 days old to 26 years old

Single Parents OR Domestic Partner Up to 65years old

Single Parent Children 15 days old to 26 years old

Domestic Partner Up to 65years old

✓ Employees aged 18 to 65 years old ✓ Dependents of employees ✓ Must Follow Hierarchy

Required Documents for the enrollment of Domestic Partner: • Affidavit of Cohabitation• Barangay Certificate• Cenomar

MBL or Maximum Benefit Limit - per illness/injury/member/year*Nationwide Access except Healthway Clinics

PLAN TYPE OFEMPLOYEES & DEPENDENTS

MAXIMUM BENEFITLIMIT

ROOM AND BOARDACCOMODATION

PLATINUM P500,000 Open Private

• Physical Examination

• Urinalysis

• Fecalysis

• Chest X-ray

• Complete Blood Count

• ECG (optional) for members 35 years old and above

• Eye Refraction

• Pap smear (optional) for Female members 35 years old and above.

Note: Annual Check-up should be for scheduling

COVERAGE LIMITS

Regular Consultations Up to MBL

Eye Laser Therapy (including cataract removal

except cost of lens)Lasik/PRK treatment - not covered

Up to P10,000 per eye / member / year

Ears, Nose, ThroatTreatment

Up to MBL

Pre and Post Natal Consultations

Treatment of minor injuries

Minor surgeries not requiringconfinement

X-ray, Laboratory exams,Routine and other diagnostic

procedures

COVERAGE LIMITSSclerotherapy – removal of Varicose veins (must be prescribed by an accredited vascular surgeon)

Up to MBLSpeech therapy (10 sessions)(medically necessary and on a reimbursement basis)

Cauterization of warts(except genital warts) P1,000/member/year

Tuberculin Test P600/member/year

Therapeutic Procedure (IV Chemotherapy, Dialysis, etc)

Subject to MBL

Physical / Occupation Therapy Up to 10 Sessions Subject to MBL

● Room and Board accommodation (based on your plan type and entitlement)

● Use of Recovery Room and Intensive Care Unit (ICU)● Professional Fee of attending doctors & nursing services● Drugs and medicines for use in the Hospital● Whole blood/human blood products & IV fluids

transfusion● Anesthesia, oxygen and its administration● Standard hospital admission kit● Dressings, casts, sutures, and other supplies/services

directly related to the medical management of the patient

MAKATI MEDICAL CENTER8th floor, Makati Medical Center

THE MEDICAL CITY12th floor, Doctors Building,

VICTOR R. POTENCIANO MEDICAL CENTER (VRPMC)

8th floor, VRP Medical Center

METRO DAVAO MEDICAL & RESEARCH CENTER (MDMRC)

7th floor, MDMRC

MANILA MED8th floor, Medical Center Manila

Roving Personnel or Liaison Officers assist Maxicare members who are confined by thoroughly explaining their coverage and informing them of the documents they need to submit before discharge.

• Doctor’s services• Emergency room fees• Medicines used for immediate relief and during treatment• Initial treatment of animal bites

• Covered up to MBL (For the first 24 hours from the time of bite)• Passive and active vaccines for animal bites

• Succeeding Dose of Anti Rabies, Anti Venom, Anti-tetanus vaccines covered up to P18,000/Member/Year

• Ambulance services• Within the network - Up to MBL • Outside the network - Reimbursable up to P3,000 per

Conduction• Involuntary for room upgrade – Covered for first 48hours

• Availment in Non-accredited hospital within the PhilippinesMaxicare shall reimburse 100% of the hospital bills and professional fees, based on Maxicare standard rates up to MBL /availment/member/year for the first 24 hours

• Outside the PhilippinesMaxicare shall reimburse the hospital bills and professional fees, based on actual cost up to MBL/availment/member/year

• Areas without affiliated hospitals within the PhilippinesMaxicare shall reimburse 100% of the hospital bills and professional fees, based on Maxicare standard rates subject to MBL.

Emergency Care Coverage(FOR NON-AFFILIATED)

CLAIMS & REIMBURSEMENT PROCEDURE

(MAXICARE REIMBURSEMENT CARD)

ü All claims may be submitted thru Member Gateway (https://membergateway.maxicare.com.ph/)

within 90 days from date of availment.

ü Scanned copy documents will be processed for now. However, members will still be required to submit hard copy within 30 days after ECQ, as this is a BIR requirement.

ü Processing of Claims will be 15 working days from receipt of complete documents.

ü Approved reimbursement shall be credited to your Maxicare Multifunction Card.

CLAIMS & REIMBURSEMENT PROCEDURE

(MAXICARE REIMBURSEMENT CARD)

The following are the required documents for reimbursement:

ü Claim Reimbursement Form for MRC (with filled out SMS number and email);ü Original receipts of all hospital bills & professional fee of the Doctor;ü Original charge slips (with itemized breakdown of charges);ü Clinical abstract, admitting history and medical certificate;ü Histopath/Surgical Report (if surgical operation was done);ü Police Report in case of accident and medico legal cases:

COVERAGE LISTPre-existing dreaded and non dreaded conditions

Up to MBL

Work related cases based on conditions set by ECC (Employee Compensation Commission)

Motor or Vehicular Accident (subject to exclusions and limitations)

Provoked / Non Provoked Assault

Consultation and treatment for Chronic Dermatoses

Scoliosis

Hepatitis B except for vaccines and screening

Congenital Conditions P20,000 /member/year

Group Life Accident Death and Dismemberment

P50,000

COVERAGE LIMIT

COVERAGE LIST

Point – of- Service (POS) Reimbursable up to 100% of Hospital Bills and Professional Fee

based on Maxicare rate.

Out-patient Medicines/Take home medicines(reimbursement)

P25,000 per family

Optical Assistance(reimbursement

P10,000 /member

Pandemic CoverageInfectious diseases (i.e Avian Flu,

Meningococcemia, etc. ) that are declared epidemic or pandemic by the Department of

Health, World Health Organization or any recognized health authority

Up to MBL

Sexually transmitted diseases, genital warts, AIDS and AIDS relateddiseases, HIV and HIV

related diseasesUp to MBL

COVERAGE LIMIT

ü Female Employees Single/ Married and Spouse of Male Employeesü LOA-facilitated if availed within the network; ü Reimbursement basis based on actual amount and subject to mentioned limits if

availed outside the network

Note: PhilHealth benefits Require to File and On top of Maternity Limit

COVERAGE LIMITS

Caesarean Section Php25,000

Normal Spontaneous Delivery Php20,000

Home Delivery Php 20,000

Miscarriage/ Abortion Php10,000

Oral Prophylaxis – three (3) times a yearSimple tooth extractionsTemporary fillings – covered as neededPermanent fillings – 2 teethEmergency dental treatmentRe-cementation of Jacket Crowns, Bridges, Inlay and Onlay Palliative Treatment of Simple Mouth Sores And BlistersGum Treatment For Cases Like Inflammation Or Bleeding Desensitization of hypersensitive teeth – 2 teethSimple adjustment of dentures

Member sets an appointmentby calling (02) 8711-0020*.

Mobile : 09175385111

*Members can also directly call their preferred dental clinics for scheduling.

Health Partners Dental Access Inc.

• Injuries arising from war or any combat-related activities while in military service

• Self inflicted injuries• Injuries from misconduct or gross negligence• Medical emergencies from beautification procedures • Chronic Dermatoses (Psoriasis, Skin Asthma)except

consultations• Government funded healthcare benefits• Personal medical requirements• Involvement in hazardous sports• Non insurable conditions• Additional charges

• Additional charges resulting from room upgrading, or additional personal comfort items not included in the room & board accommodation ( T.V., telephone, etc.)

• Corrective appliances, artificial aids, prosthetic appliances• Take home medicines• Services obtained from Non-accredited Physicians and

hospitals or other provider of care, except under emergency care.

• Purchase or lease of durable medical equipment, oxygen dispensing equipment, and oxygen except during covered in-patient care.

• Custodial, domiciliary and convalescent care.• Long-term rehabilitation and Psychiatric care.• Dental and maternity cases• Circumcision, sex transformation, diagnosis and treatment of fertility or

infertility, artificial insemination, sterilization or reversal of such.• All expenses incurred in the process of organ donation and

transplantation, unless the Member thereof is the recipient of such donation or transplantation.

• All physical deformities prior to enrolment• Experimental medical procedures, acupuncture• Hepatitis B screening and all diagnostic examinations for Members who

have pre-existing Hepatitis B.

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