Overview of Medicard Philippines
MediCard Philippines provides an array of medical insurance schemes for Individuals & Family, Group & Corporates & VIP Assistance with benefits that provide monetary cover for a wide range of medicals needs. Founded in 1987, Medicard Foundation, Inc. is a non profit organization headquartered in Makati City.
Health Insurance Schemes Offered by MediCard in Philippines
Individual & Family Program
This option covers individuals (Principal member) along with the family members. The annual premium is computed on the basis of the type of ward chosen the number of persons covered in the policy. This program provides monetary cover for hospitalisation due to accident or illness and covers room charges, surgical costs, medication and a host of other costs involved in hospital confinement.
Group & Corporate Program
The group plan applies for SMEs with coverage for 5 to 10 members between the age of 18 to 60 years. On the other hand, the Corporate Program requires at least 11 principal members between the same age band. This plan provides coverage for hospitalization due to accident or illness. Services such as Outpatient care, Emergency care, Preventive health care, Financial assistance and Dental care are available based on the coverage chosen by the employer.
MediCard has tied up with Assist America to bring to you, medical consultation and evaluation, referral to physicians, medical assistance in case of emergency and hospital admission if you’re travelling for more than 150 kilometers in less than 90 days. This program also provides assistance with reimbursement of medical expenses and covers costs of transportation.
The MediCard VIP plan also provides other benefits such as access to 5 star hospitals in the country, coverage for preexisting conditions, executive health check up and a lot more.
Features and Benefits of Medicard Schemes
Coverage for Inpatient Services
Based on the the physician's prescription, the insured can seek admission in any of the MediCard network hospitals or MediCard centers. A wide range of treatment and services are covered that includes admission and room boarding, specialist services, X-ray and laboratory examinations, medicines and all other related needs along with surgical procedures.
Preventive Health Care
MediCard also provides preventive healthcare services to members to ensure health status is regularly monitored to determine any ailments or health issues. It offers Annual Physical Examination(APE) to members at MediCard head office or any of the designated centers. It also covers immunization(excluding the cost of vaccines), medical history record keeping & counselling services.
MediCard members are eligible for specialised care in the event of a life threatening illness or injury. Emergency services such as access to specialised doctors, medicines used for immediate relief, oxygen and intravenous fluids and other needs are covered. It also provides reimbursement for emergency care availed at non-MediCard accredited medical facilities.
Members Financial Assistance
MediCard health provides monetary compensation in the event of death or injury. The life indemnity program provides financial assistance to the insured member as well as immediate family members in case of fatality. Compensation is provided for natural death, loss of limbs & loss of sight.
Dental care services can be availed from any of the accredited dental clinics in the country. Services such as oral prophylaxis(once in an year), oral consultations and examinations, tooth extractions & fillings and other facilities are provided for MediCard members.
Eligibility for Medicard
Individual & Family Program
The principal member should be salaried or self employed between the age of bracket of 18 to 60 years.
Eligibility for married principal members:
- Spouse should be atleast 18 years with an upper cap of 60 years.
- Dependent children between the age of 30 days to 21 years are eligible. The child should be unmarried and unemployed living in the same house as the principal member.
Eligibility for single principal members:
- Dependent and unemployed parents up to the age of 60 are eligible.
- Siblings between the age of 30 days to 21 years can also be enrolled as dependent members. They should be unmarried and be living under the same roof as the principal member.
Group & Corporate Program
- The group plan is available for SMEs only. This program should have 5 to 10 members between the age band of 18 to 60 years.
- Corporate program is available with for a min. of 11 members between the age band of 18 to 60 years.
- What is the coverage amount for Modern therapeutic modalities and interventional surgical procedure?
- Please provide a complete list of outpatient care services provided by MediCard.
Not limited to laparoscopic surgery and lithotripsy, the coverage amount is up to P20,000 each year subject to pre existing conditions coverage.
The following services are provided by MediCard at accredited hospitals and clinics.
- Specialist referrals
- Routine consultation and treatment. Medication prescribed is not covered.
- Ear, Eye, Nose & Throat Treatment which do not require surgical intervention leading to hospitalization.
- Treatment of injuries and surgeries that do not require hospitalization.
- Lab examination & X-Ray as prescribed by the consulting Physician.
- Complete blood count
- Chest X-ray
- Pap Smear
Some of the tests above are only provided if indicated to a certain age group and sex.
Any individual who travels frequently can avail this plan as it secures medical assistance, treatment and reimbursement at network hospitals. To extend the convenience of accessing top notch medical facilities in various countries, MediCard has tied up with America Assist, a leading emergency service provider for travellers around the globe.
The following documents are required as a part of the claims process.
- MediCard membership details(card)
- Death Certificate(Original)
- Affidavit of next of kin/marriage agreement
- Notarised Physician's statement
- Police report in case of accident
- Principal member’s employment certificate