• Pioneer Health Insurance

    Pioneer Health Insurance

    Overview of Pioneer Insurance

    Pioneer Insurance & Surety Corporation is a leading life and general insurance company in Philippines with products catering to individuals, corporates as well as offering for industry based needs such as Aviation & Cargo. Founded in 1954, this Makati City headquartered insurance corporation is an industry leader in sectors such as marine, aviation and cargo. The group has many subsidiaries dealing with specific industry and target group based insurance products.

    In the health insurance segment, Pioneer provides a massive range of products in categories of Accident & Health Insurance & Health only.

    Health Insurance Schemes offered by Pioneer in Philippines

    Accident & Health Insurance:

    1. All Purpose Personal Accident Card: A gift card for your loved ones with Personal Accident Coverage.
    2. Hospital Aid: A program that covers expenses arising out of confinement in hospital due an accident or illness. Covers family members as well.
    3. Keymancare: A comprehensive package for head of the family with cash benefits up to P5 million.
    4. Personal Accident Coverage: Provides cover to expenses arising out of hospitalization due to an accident.
    5. Safe & Sound: This program provides monetary benefits in case of a serious accident to the insured member.

    Health Only:

    1. Global Health: A tailor made plan for high networth individuals that provides comprehensive health benefits such as hospitalization and surgical cover, repatriation and evacuation along with access to quality healthcare around the globe. This program is available in three variants.
    2. AAA Plan

      Provides complete medical coverage which includes outpatient benefits and comes with an annual limit of $2 million.

      AA Plan

      Medical coverage that focuses primarily on core surgical & hospitalization benefits and comes with an annual limit of $2 million.

      A Plan

      Same medical benefits as the AA plan with an annual limit of $500,000.

    3. Medicash: An exclusive health insurance product designed to provide medical cash assistance upon diagnosis of the disease(listed) covered. The insured member can claim non hospitalization cash benefits of up to P10,000 as a lump sum amount. This scheme covers Dengue and Leptospirosis.

    Features and Benefits

    Hospital Aid

    • The insured member can extend the benefits of this plan to spouse(below 60 years) and children(Unmarried and Unemployed - from 3 months to 20 years). Payment of cash benefits starts right from day 1 of hospital confinement.
    • A daily cash benefit of P1,500 is provided during hospital confinement right from day one and P3,000 if the insured member is confined in ICU(Intensive Care unit) for up to 31 days.
    • Coverage of surgeon’s fee of up to P15,000. The maximum fee disbursed will be done according to the schedule of operations. The payment is settled directly with the insured member.
    • Maternity benefits of P1,500 up to a period of 7 days. This benefit can be availed only if the mother is insured for a minimum of 10 months.


    • A Daily Sickness Benefit of up to P2,000 for 12 months for loss of income if the insured is hospitalised due to sickness. In the event of loss of life, Pioneer provides a Cash Assistance Benefit in the tune of P10,000 to the immediate family members.
    • This plan also extends a Daily Accident Hospital Benefit of up to P2,000 to cover the loss of income if the insured is hospitalised for recovery. It also provides a reimbursement for the medical expenses of up to P500,000 for treating injuries arising out of an accident.
    • The program goes an extra mile by offering a compensation of up to P5 million in the form of Unprovoked Murder & Assault Benefit if the insured is victimised by any of these crimes.
    • The Loss of Life, Disablement Benefit offers cash assistance of up to P5 million if the insured member meets with an accident that results in death, disablement or dismemberment within 180 days of the incident.

    Safe & Sound

    • A comprehensive protection plan that offers medical benefits on the go that is valid internationally and covers simple mishaps to tragedies abroad.
    • Extends monetary compensation if the accident results in loss of life, disablement or dismemberment. This benefit should be availed within 180 days from the date of accident.

    The following optional benefits can be added to enhance the coverage value.

    Accident Medical Expense Benefit: Pays for the medical or surgical treatment up to the maximum benefit amount in case of injuries arising out of an accident. This option also covers nursing fees and costs of hospitalization for up to 52 weeks from the date of accident.

    Daily Accident Hospital Benefit: A compensation amount is paid in the event of confinement in hospital due to an injury as a result of an accident. This benefit can be claimed within 30 days from the confinement period.

    Cash Assistance Benefit: Pays monetary benefits to the family members in the event of loss of life.

    Murder and Assault Benefit: Provides compensation in case the insured member becomes victim of unprovoked murder or assault.

    Health Only

    Global Health

    • As described earlier in the article, the A plans not only cover treatment of injuries arising out of an accident, but also extends medical benefits for chronic conditions & illness across the globe.
    • The Global Health A plans are offered in association with GlobalHealth Asia - A leading third party administrator in the region.
    • This program is tailor made for high net worth individuals and globetrotters who are constantly on the move providing them seamless features and benefits of international standards.
    • Depending on the product chosen, a host of benefits such as surgical, medical assistance round the clock, emergency evacuation and repatriation are available at the disposal of the insured member.
    • Plans under this program goes an extra mile by offering Dental & Maternity benefits as an option along with deductibles for lower premium.

    Eligibility for Pioneer Insurance

    • This program is available for people between the age band of 0 - 65 years.
    • Policy renewal can be done until the age of 80 years on an annual basis.

    Policy Exclusions

    Pre existing conditions(unless declared and accepted during underwriting), Cosmetic surgery, Hearing aids, Routine medical exams, Nutritional supplements & Vitamins, Fertility treatment, Spectacle frames & Lasik surgery, Treatment for substance abuse, learning difficulties, sleeping disorders & behavioral disorders.


    • Provides medical cash assistance if the insured member is diagnosed with Dengue or Leptospirosis.
    • The insured can claim cash benefits of up to P10,000 as a lump sum in case of hospitalization or otherwise for treatment of any of the listed diseases.
    • A one time premium payment ensures coverage for 1 to 70 years old for one year without any medical tests.
    • The waiting period to claim the cash benefit is just 15 days. Cash benefit is payable to the insured or any of the legal dependents.
    • This medical insurance policy can be easily signed up for by just filling up a form with little stress on extensive documentation.

    Pioneer Insurance FAQs

    1. What are the exclusions of the Pioneer Hospital Aid program? Can you please list out the things not covered?
    2. This program does not cover the following.

      • Self inflicted injuries or self destruction, war, service in armed forces & congenital anomalies.
      • Cover for pre-existing medical conditions unless the insurance has been effective for 12 months consecutively.
      • Plastic & Cosmetic surgery, Rest Cures/Check Ups, Dental Treatment, Eye Check up(eye injuries are covered), Drug/Alcohol Addiction, Mental/Nervous disorders.
    3. Does the Keymancare program consider the occupation of the insured worker?
    4. Yes, it does consider the occupation. Benefits are customised based on the type of work. Class 1 consists of “White Collar” workers involved in office work and Class 2 keeps in mind, needs of “Blue Collar” workers involved in manual labor.

    5. Can the cover under the Pioneer Safe and Sound be extended to immediate family members as well?
    6. The cover under this program can be extended to immediate family members. Details have been provided below.

      • Married member can cover spouse(at least 18 years old and less than 70 years) and children who are unemployed and unmarried(1 to 21 years of age).
      • Single member can include parents(less than 70 years of age) along with children who are unemployed and unmarried(1 to 21 years of age)
    7. Please provide more details on the “Deductibles” option available under the Global Health A plans.
    8. Since this is US Dollar currency plan, the deductible options available are $500, $1000, $2000 & $5000.

    9. I would like to know the phone number for Pioneer Health Insurance.
    10. You can reach them on Tel: +63 2 812 7777 or also log on to pioneer.com.ph for details on products.

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