Friday, March 29, 2024

Body in Health, Mind at Peace

Body in Health, Mind at Peace

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MyMaxicare’s full and extensive HMO coverage gives us one less thing to worry about in the midst of this ongoing health crisis.

 

If there’s one thing this pandemic has taught us, it’s that health is our most valuable asset. Despite the imminent threat of serious illness, we need to keep our bodies safe and find ways to tide through expenses if ever we get sick.

 

No doubt, this uncertainty on where to pull and pool funds from is the root of a lot of our pandemic anxieties, and it’s normal. Because of extra safety measures that they have to take, hospitals have to raise their prices. And as household decision makers—whether of our family or of our own solo households—we are committed to taking proper care of ourselves and our families by providing for them and securing their health as best as we can.

 

The easiest, quickest and even best option for securing one’s health is to procure a reliable HMO for you and your family. But with so many HMO plans available, the anxiety piles up even more when faced with deciding on which HMO plan to choose: which HMO will offer the most comprehensive coverage? Which HMO will feature the widest network of healthcare providers?  Which HMO is affordable but will provide the best healthcare for me and my family? And in those two respects, which HMO is best?

 

MyMaxicare is the most respected HMO plan for individuals and families alike. It is a full-risk, full coverage healthcare plan that offers a comprehensive coverage, with the widest network of hospitals, clinics, and providers in the Philippines. Truly perfect for families of any size and covering a wide age range, MyMaxicare is eligible for individuals and their dependents as young as 15 days old, and as old as 60 years and five months old.

 

From as early as a few weeks old to the golden years, MyMaxicare provides the following benefits to its clients:

 

  1. Inpatient Benefits

From room and board accommodation, professional physician fees, anesthesia and oxygen administration, to laboratory procedures—see the FAQs for full list.

 

  1. Outpatient Benefits

Regular consultations, minor surgeries, diagnostic procedures, speech therapy, and therapeutic procedures such as chemotherapy and dialysis—see FAQs for full list.

 

  1. Emergency Care

Emergency Room access in Maxicare-affiliated hospitals, and a wide set of inclusions for non-affiliated hospitals within the Philippines, areas within the Philippines without Maxicare- affiliated      hospitals, and even outside the Philippines subject for reimbursements—see FAQs for complete inclusions.

 

  1. Maxicare Primary Care Center

There are 10 Maxicare-owned state-of-the-art healthcare clinics where members get the exclusive care they deserve. See FAQs for full list.

 

  1. Preventive Care

Vaccination for tetanus and animal bites, as well as monitoring and counseling on health and wellness concerns—see FAQs for full list.

 

  1. Annual Check-Up

Physical examination, fecalysis, urinalysis, chest X-ray and complete blood count.

 

  1. Value-Added Benefits

Maxicare has partnered with Assist America Asia Limited to provide you with global emergency assistance services. This program immediately connects you to qualified healthcare providers, hospitals, pharmacies and other services if you encounter an emergency while traveling more than 150km away from your permanent residence, or in another country, for up to 90 days. Services are available 24 hours a day, 365 days a year, anywhere in the world. This service is accessible via the Assist America mobile app in both the App Store and Google Play.

 

See FAQs for full list of inclusions for both Medical and Non-Medical emergency assistance.

 

  1. Dental Care (optional)

Annual oral dental examinations, emergency dental treatments, permanent and temporary fillings, annual oral prophylaxis and simple tooth extractions, among others—see FAQs for full list.

 

There are four MyMaxicare plans to choose from, each with their own maximum benefit limit per individual and dependent:

 

 

MyMaxicare Plan Maximum Benefit Limit Room & Board Accommodation
Platinum Plus PHP 200,000 Large Private Room
Platinum PHP 150,000 Regular Private Room
Gold PHP 100,000 Regular Private Room
Silver PHP 60,000 Semi-Private Room

*Per illness, per member, per year

 

Each MyMaxicare plan is customizable customizable to fit any financial capacity, plans can be paid annually, semi-annually or quarterly, with online payment methods available. Committed to protect the health of the whole family, MyMaxicare also covers the following dependents:

 

Married Single Single Parent
Spouse: up to 60 years and five months old Parents: up to 60 years and five months old Children: 15 days old to 21 years and five months old
OR
Children: 15 days old to 21 years and five months old Siblings: up to 21 years and five months old Parents: up to 60 years and five months old

 

MyMaxicare covers pre-existing conditions, subject to limits that vary per plan type and the number of years of membership. For more information on pre-existing conditions, contact Maxicare via: (02)85821900 (PLDT) or (02)77987777 (Globe)     .

 

With the wide array of HMO plans available, it truly pays to be presented with the best options that will put your mind at ease—not just for you, but for your family. Get #MaximumCareMinimumWorry with the most comprehensive medical coverage and widest network of healthcare providers, proving that #MyMaxiCARESForMe, and #MyMaxiCARESForMyFamily.

 

 

FAQs

 

Who are eligible for a MyMaxicare healthcare plan?

Individuals and their dependents

  1. Starting at infants 15 days old.
  2. Up to 60 years and five months old.
  3. For existing MyMaxicare enrollees, MyMaxicare can be renewed up to 65 years of age.

 

 

 

ELIGIBLE DEPENDENTS

 

Married Single Single Parent
Spouse: up to 60 years and 5 months old Parents: up to 60 years and 5 months old Children: 15 days old to 21 years and 5 months old
OR
Children: 15 days old to 21 years and five months old Siblings: up to 21 years and five months old Parents: up to 60 years and five months old

 

How much is the Maximum Benefit Limit per plan type for Individuals and their Dependents?

 

MyMaxicare Plan Maximum Benefit Limit Room & Board Accommodation
Platinum Plus PHP 200,000 Large Private Room
Platinum PHP 150,000 Regular Private Room
Gold PHP 100,000 Regular Private Room
Silver PHP 60,000 Semi-Private Room

*Per illness, per member, per year

 

What are the available modes of payment for the plans?

  • Semi Annual.

Online payment option available

 

Does MyMaxicare cover pre-existing conditions?

  • Yes, MyMaxicare covers pre-existing conditions and are subject to limits that vary per plan type and the number of years of membership.

 

What are the benefits?

 

  1. Maxicare Primary Care Centers

These are Maxicare-owned state-of-the-art healthcare clinics where members get the exclusive care they deserve.



ALABANG (Southkey Hub)

ANGELES, PAMPANGA (SM City Clark)

BGC (W City Center)

CEBU CITY (Cebu Business Park)

DAVAO CITY (Abreeza Mall)

 

ILOILO (Three Techno Place)

MAKATI CITY (Ayala North Exchange)

PASAY CITY (Double Dragon Meridian Park)

QUEZON CITY (Bridgetowne)

(Eton Centris)

 

  1. Inpatient Care Benefits
  1. Room and board accommodation.
  2. Use of operating room, Intensive Care Unit (ICU), isolation room (if prescribed), and recovery rooms
  3. Professional Fees of Attending Physicians, Surgeons, Anesthesiologist and Cardiopulmonary clearance before surgery and cardiac monitoring during surgery
  4. Standard nursing services
  5. Medicines for in-patient use
  6. Blood product transfusions and intravenous fluids, including blood screening and cross matching
  7. X-ray, laboratory examinations, diagnostic tests and therapeutic procedures incidental to confinement
  8. Dressings, conventional casts (plaster of Paris) and sutures
  9. Anesthesia and its administration
  10. Oxygen and its administration
  11. Standard admission kit
  12. All other items directly related in the medical management of the patient, as deemed medically necessary by the attending accredited physician

 

  1. Outpatient Care Benefits

 

  1. Regular consultations (except prescribed medicines).
  2. Eyes, ears, nose, throat treatment (prescribed by an accredited physician specialist).
  3. Eye laser therapy (including cataract removal except cost of lens).
  4. Treatment for minor injuries such as lacerations, mild burns, sprains, and the like.
  5. Dressing, conventional casts (plaster of paris) and sutures.
  6. Minor surgeries not requiring confinement.
  7. X-ray, laboratory exams, routine and other diagnostic procedures.
  8. Sclerotherapy (must be prescribed by an affiliated vascular surgeon).
  9. Allergy testing/ allergy screening (prescribed by an accredited physician).
  10. Cauterization of warts (except genital warts).
  11. Speech therapy (medically necessary and on a reimbursement basis).
  12. Tuberculin test.
  13. Therapeutic procedure (IV chemotherapy, dialysis, etc.).
  14. Other modalities.

 

  1. Emergency Care Process and Benefits
  1. For Affiliated Hospitals
  2. Doctor’s services.
  3. Emergency room fees.
  4. Medicines used for immediate relief and during treatment.
  5. Oxygen, intravenous fluids and blood products.
  6. Dressings, conventional casts (plaster of paris) and sutures.
  7. Initial treatment of animal bites shall be covered for the first twenty-four (24). hours from the time of bite.
  8. X-rays, laboratory, diagnostic examinations and other medical services related to the emergency treatment of the patient.

 

  1. For Non-Affiliated Hospitals
  • Within the Philippines

Maxicare shall reimburse up to 80% of the actual hospital bills and 80% of the professional fees based on Maxicare rates incurred during the first twenty-four (24) hours of treatment up to PHP 30,000 per availment per member.

  • Areas without accredited hospitals within the Philippines

Maxicare shall reimburse 100% of the total hospital bills and professional fees based on Maxicare rates.

  • Outside the Philippines

Maxicare shall reimburse 100% of actual costs up to PHP 30,000 per availment per member.

 

  • Ambulance Service

 

  1. Preventive Care Benefits
  2. Vaccination for treatment of tetanus and animal bites.
  3. Periodic monitoring of health problems.
  4. Health education and counselling on diets and exercise.
  5. Health habits & family planning counselling.
  6. Wellness programs.

 

  1. Annual Check-up Benefits (ACU)
  2. Physical examination
  3. Fecalysis
  4. Urinalysis
  5. Chest X-ray
  6. Complete blood count

Annual Check-up should be for scheduling.

 

  1. Value Added Benefits

MAXICARE’S INTERNATIONAL ASSISTANCE PROGRAM

Maxicare has partnered with Assist America Asia Limited to provide you with global emergency assistance services. This program immediately connects you to qualified healthcare providers, hospitals, pharmacies and other services if you experience an emergency while traveling more than 150km away from your permanent residence, or in another country, for up to 90 days. Services are available 24 hours a day, 365 days a year, anywhere in the world.

 

  1. Medical Emergency Assistance
  • Emergency medical evacuation
  • Emergency medical repatriation
  • Medical referral
  • Medical monitoring
  • Prescription assistance
  • Foreign hospital admission assistance
  • Return of mortal remains
  • Compassionate visit
  • Care of minor children

 

  1. Non-Medical Emergency
  • Emergency message transmission
  • Lost luggage or document assistance
  • Legal and interpreter referrals
  • Pre-trip information
  • Mobile app services

 

To activate Assist America’s services, you may download the FREE Assist America Mobile App from the App Store for Apple devices or Google Play for Android devices.

           

  1. Dental Care Benefits
  2. Annual oral/dental examinations and consultations
  3. Emergency dental treatment
  4. Annual oral prophylaxis
  5. Simple tooth extractions
  6. Restorative and prosthodontic treatment planning
  7. Permanent fillings (two teeth)
  8. Unlimited temporary fillings (covered as needed)
  9. Desensitization of hypersensitive teeth (two teeth)
  10. Simple adjustment of dentures
  11. Recementation of loose crown, inlays or on-lays
  12. Dental nutrition and dietary counseling
  13. Dental health education