• Caritas Health Shield Inc.

    Caritas Health Shield Inc.

    Overview of Caritas Health Shield

    Caritas Health Shield, Inc. is a leading healthcare service provider in Philippines with an extensive network that consists of over 703 hospitals and 192 clinics & laboratories serviced 107 branches across the length and breadth of the country. Set up in 1995, Caritas provides a full range of medical services to an ever growing customer base of over 574,000 members in the network.

    An active member of the AHMOPI(Association of Health Maintenance Organizations), the organisation has multiple subsidiaries in the field of medical care and research such as Caritas Life Insurance Inc. , Caritas Family Hospital, Caritas Health Shield Foundation, Caritas Urology Center and many more which speaks volumes of its commitment and responsibility to administer quality healthcare to the Filipino family. The corporate headquarters of Caritas is based in Quezon City.

    Health Insurance Schemes offered by Caritas Health Shield in Philippines

    The group administers 5 types of healthcare programs integrating health cover, financial services and life into all its products. The following are the health insurance schemes offered by Caritas as a Health Management Organization(H.M.O).

    1. Expanded GOLD Health Care Program
    2. A comprehensive healthcare program that limits premium payment to 5 years and provides yearly increment in the Maximum Coverage Amount and benefits. A one of its kind plan which provides access to a medical network consisting of over 361 hospitals and 192 clinics and laboratories.

    3. Expanded PREMIER Healthcare Program
    4. A near clone of the GOLD healthcare program that offers comprehensive benefits at affordable prices. A 5 year pay plan that protects from premium hikes and offers top notch hospitalization benefits, emergency care and a host outpatient services along with a slew of other features covering all possible costs and treatments.

    5. Expanded PRIME Plus Healthcare Program
    6. A value for money plan which extends sufficient health cover for the insured and family members and also protects from premium increases over a 5 year pay plan. With a guaranteed 5% increment from the 7th or 11th year onwards, this affordable scheme covers pre existing illnesses and provides additional health benefits during the expanded period of coverage.

    7. Expanded CORE - 10 Health Care Program
    8. An exclusive program designed for employees where the premium can be paid by by the enrolling member through Salary Savings Scheme (Salary Deduction). This affordable plan which provides the most comprehensive health benefits to the workforce coupled with protection from premium hikes through a 5 year pay plan.

    9. COMBI Plan
    10. This plans clones the benefits offered by the Expanded Core Health Care Program along with pension benefits of the Caritas Fund provider. It not only provides medical services on par with industry standards, but also extends financial security from the pension plan. Hospitalization, Outpatient services, Preventive health care, Coverage for pre existing illnesses are some features of this plan. The insured member can also avail the pension benefit as a lump sum payment.

    Features and Benefits

    1. Expanded GOLD Healthcare Program
      • Uniform premium amount with protection from hikes though a five year pay plan which implies no fluctuation in the premium amount.
      • Upon payment of the first installment, an annual increase in Maximum Coverage Amount per illness and Maximum Daily Room Rate is assured on an incremental basis. The benefit continues for an additional period of 1 to 5 years after the paying period.
      • The medical expense benefits consists of Hospitalization Benefits, Emergency Care and Special Diagnostic & Lab procedures.
      • The membership privileges package includes Outpatient Services, Dental Care, Annual Physical Examination, Preventive Healthcare and other other benefits.
      • A range of other benefits such as cover for pre existing illnesses, grace period, additional benefits from 7th and 11th year onwards add great value the existing provisions.
      • A salient yearly increment of 5% is given to build the Expanded Benefit Limit. If there is no claim made during the entire pay period, the increment is guaranteed at 8%.
    2. Expanded PREMIER Healthcare Program
      • Uniform premium amount through a 5 year plan that protects the insured member from premium increases during the paying period.
      • Annual increment in Maximum Daily Room Rate and Maximum Amount of Coverage is guaranteed after payment of the first installment for medical benefits.
      • Medical Benefits Package includes Hospitalization Benefits, Emergency Care & Special Diagnostic & Lab procedures.
      • The all inclusive Membership Privileges Package consists of Outpatient services, Annual Physical Examination, Dental Care, Preventive Health Care and other primary services.
      • A host of benefits such as Pre existing illness coverage, Enhanced benefits during the expanded period of coverage, grace period benefits etc. makes this program a comprehensive one.
      • An annual increment of 5% is provided on the Expanded Benefit Limit with a potential to increase it to 8% if Medical Expense Benefits are not availed during the entire paying period.
    3. Expanded PRIME Plus Healthcare Program
      • An uniform premium amount throughout the paying period for 5 years is guaranteed. The insured member is shielded from fluctuations in market conditions.
      • An yearly increment in Maximum Amount of Coverage and Maximum Daily Room Rate is assured upon completion of the first installment for medical benefits.
      • The responsive Medical Benefits Package is composed of Hospitalization Benefits, Emergency Care and also covers Special Diagnostic & Lab Procedures.
      • Option to choose Free Annual Physical Examination(APE) for 6 or 10 years to help you keep a tab on key health determinants.
      • Guaranteed increment of 5% annually on the Expanded Benefit Limit and a potential to get a hike of 8% if no Medical Expense Benefit is availed during the paying period.
      • In addition to the benefits above, additional features such as Coverage of pre-existing illnesses, Provisions of transfer and assignment, Grace period options makes this program, a comprehensive cover.
    4. Expanded CORE - 10 Health Care Program
      • The company and its employees are shielded from premium fluctuations through a 5 year pay plan with uniform premium payment during this term.
      • The Maximum Amount of Coverage & Daily Room Rate doubles with each passing year after the first installment for the employee's’ medical benefits. This benefit continues for an additional period of 5 years after the paying period is over.
      • The Responsive Medical Benefits Package includes Emergency Care, Hospitalization Benefits along with Special Diagnostic and Lab Procedures.
      • The comprehensive Membership Privileges Package is composed of Outpatient Services, Annual Physical Examination, Dental Care, Preventive Health Care among a host of services that can be availed at designated diagnostic centers.
      • This program also includes features such as coverage of Pre-existing illnesses, Provisions of transfer to a different person, Grace period benefits etc.
    5. COMBI Plan
      • Pension Benefits are available from the 11th year with option to choose from Lump Sum payment, Interest payment plus Pension benefit and Partial withdrawal plus Interest settlement along with the health benefits as described below.
      • During the 5 year pay plan, the insured member is protected from premium increases with a uniform amount throughout the period.
      • Annual increment in Coverage Amount(Maximum) per year and Daily Room Rate is guaranteed under this program. This benefit continues for an additional period of 5 years after the initial paying period.
      • The comprehensive Membership Privileges Package is composed of Outpatient Services, Annual Physical Examination, Dental Care, Preventive Health Care among a host of services that can be availed at designated diagnostic centers.
      • The Responsive Medical Expense Benefits package consists of Hospitalization benefits, Special Diagnostic and Lab Procedures & Emergency Care Services.

    Common benefits such as membership in Caritas Health Shield extends round the clock health protection with a nationwide coverage that spans across a network of 361 hospitals and 192 clinics and laboratories. In house diagnostic, medical services & laboratory arm Clinica Caritas has over 40 branches which can be used to secure various healthcare needs of you and your loved ones.

    Caritas Health Shield FAQs

    1. Where can I get a list of network hospitals of Caritas Health Shield?
    2. The list of network hospitals and clinics is available on the website of Caritas. The list can be accessed on the home page by clicking on the Medical Network menu. You can choose from the drop down options.

    3. How do I contact Caritas for a query on the medical insurance I have availed from them?
    4. You can call them on (02) 711 - 2411 or (917) 8733882/(922) 8978635. The phone services are available 24 hours a day, 7 days a week.

    5. We are a small firm looking for a health insurance that covers our employees. Does Caritas provide a tailor made program?
    6. The Expanded CORE - 10 Health Program is an exclusive program customised for corporate and SME customers. This highly affordable scheme provides all round health coverage with a slew of features, benefits & annual increments.

    7. Is there a health insurance plan that provides pension benefit as well?
    8. The Caritas COMBI plan consolidates health insurance & pension benefits that can be availed as a lump sum or partially along with interest charges.

    9. When can I charge a Medical Expense incurred by a family member to the Expanded Benefit Limit?
    10. The charges can be made on the 7th or 11th year onwards.

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