MediCard Select
DESCRIPTION
MediCard Select is an innovative solution that allows members of all ages to avail themselves of healthcare coverage for minimum fees and management of fund. Best of all, members only pay for what is utilized and unused funds shall be returned.
MediCard Select offers a suite of benefits that give members of all ages the coverage they need. Qualified individuals, families or SMEs will receive coverage for hospitalization, outpatient, and preventive healthcare that includes Annual Physical Exam and the following 8 blood chemistries- Fasting Blood Sugar, Total Cholesterol, Uric Acid, Creatinine, BUN, HDL, LDL and Triglycerides.
Moreso, those who are qualified for membership will have emergency and dental benefits. Dental benefits cover tooth extractions, consultations and oral examinations, oral prophylaxis and more.
Rules and limits apply.
Note: Information on this online store is valid until updated.
[Last update: May 15, 2022]
BENEFITS
HOSPITALIZATION BENEFITS
- No deposit upon admission
- Room & Board: Regular Private Open
- Use of operating theatre and Recovery Room
- Services of MediCard specialist like anesthesiologists, internists, surgeons, etc.
- Services and medications for general/spinal anesthesia or other forms of anesthesia deemed necessary for a surgical procedure
- Fresh whole blood transfusions and its processing/screening and intravenous fluids
- X-ray and laboratory examinations
- Administered medicines
- Dressings, plaster casts, sutures, etc.
- ICU confinements
- Chemotherapy
- Radiotherapy
- Dialysis
- Human blood products and its processing/screening including gamma globulin
- Admission kit including wee bag
- Laparoscopic Procedures
- Lithotripsy/ESWL
- Hysteroscopic Procedures
- Stereotactic Brain Biopsy / Stereotactic Breast Biopsy
- Gamma Knife Surgery
- Percutaneous Ultrasonic Nephrolithotomy
- Transurethral Microwave Therapy (TUMT) of the prostate
- Arthroscopically-guided Procedures
- CT Scan / MRI / Ultrasound guided excisions
- Endoscopically-guided excisions / treatments / procedures
- Intradiscal Electrothermal Therapy (IDET)
- Laser/Coblation Tonsillectomy
- Endovenous Laser Therapy/Endovenous Laser Ablation/Radiofrequency Ablation (except for cosmetic purposes)
- Coblation Procedures
- Ductoscopy (Breast) guided excisions/treatment/procedures
- Endoscopic Ultrasound guided excisions/treatment/procedures
- Infrared Coagulation Hemorrhoidectomy
- Mammotome/Vacuum Assisted Breast Biopsy
- Stereotactic Radiation Therapy / Stereotactic Radiosurgery
- Thyroplasty (implant not covered)
- Transarterial Hemorrhoidal Dearterialization (THD)
- Ultroid Hemorrhoid Management
- Any other modern therapeutic procedure not mentioned above
- Magnetic Resonance Imaging (MRI) / Magnetic Resonance Angiography (MRA)
- CT Scan
- Ultrasound
- Robotic Surgery / Robotically-assisted Surgery
- Photodynamic Therapy
- Acoustic Radiation Force
- Capsule Endoscopy
- New diagnostic and treatment procedures for conditions with established etiologies and its use is only as alternative to the conventional methods
- Laboratory/ancillary services for conditions whose pathogenesis or subsequent clinical improvement is not yet fully established in Medical Science
- Other medically necessary modalities not mentioned above and those for which there are no comparable, conventional or traditional counterparts
- Positron Emission Tomography (PET) Scan
- Stapled Hemorrhoidectomy
- Cryosurgery
- Work-related illness/accidents
- Unprovoked/Provoked Assault
- Hyperventilation syndrome
- Congenital Illnesses (regardless of PEC limit)
- Slipped Disc, Scoliosis, Spondylosis, Spinal Stenosis
- Open heart surgery (including cost of stent and pacemaker)
- Organ transplant (including cost of organ and donor’s expense)
- Complex diagnostic examinations and therapeutic procedures
- Professional fee of the assisting physician in surgical procedures
- All other items directly related to the management of the case
- Visitation of MediCard liaison officer
-
OUTPATIENT CARE
- Referral to specialists
- Regular consultations & treatment
- Eye, Ear, Nose & Throat treatment
- Treatment of minor injuries and surgery not requiring confinement
- X-ray and laboratory examinations prescribed by MediCard physician
- Physical Therapy / Speech Therapy
- Laser treatment of Glaucoma & Retinal Detachment
- Cataract Extraction including phacoemulsification and cost of lens
- Cauterization of warts (including facial warts)
- Doses of anti-rabies, anti-venom, anti-tetanus
- Tuberculin Test (including screening)
- Pre & Post-natal consults Covered; including labs
- Sclerotherapy (including cost of sclerosing agent)
- Chronic Dermatoses
- Scabies
- Allergy Testing
- Annual Physical Examination (APE) to include:
- Complete Blood Count
- Urinalysis (urine examination)
- Fecalysis (stool examination)
- Chest X-ray
- Electrocardiogram
- Pap smear
- Eight Blood Chemistries: Fasting Blood Sugar, Total Cholesterol, Uric Acid, Creatinine, BUN, HDL, LDL and Triglycerides – for members 30 years old and above
- Anti-flu vaccines – for members below 30 years old
- Management of health problems
- Routine immunization
- Counselling on health habits, diets and family planning
- Record keeping of medical history
NOTE: APE may be conducted at any MediCard-free standing clinic
EMERGENCY CARE
- Emergency Care in MediCard-Accredited Hospitals/Clinics
- Doctor’s services
- Medicines used during treatment or for immediate relief
- Oxygen and intravenous fluids
- Dressings, plaster casts, and sutures
- Laboratory, X-ray and other diagnostic examinations
- Emergency Care in Non-MediCard Accredited Hospitals: MediCard agrees to reimburse 100% of Approved Hospital Bills and Professional Fees based on MediCard Relative Value (MRV)
- When a member is in immediate danger of losing a limb, eye or other parts of the body or is in severe pain that requires immediate relief and enters a non-MediCard accredited hospital for treatment.
- MediCard shall pay the said amount when it is verified that MediCard facilities were not used because to have done so would entail a delay resulting in death, serious disability or significant jeopardy to the member’s condition or the choice of hospital was beyond the control of the member or the member’s family. Other expenses not covered in using non-MediCard Accredited Hospitals for emergency care is follow up care.
- Emergency Care in Foreign Countries
- MediCard shall reimburse one hundred percent (100%) of the approved total hospital bills and of professional fees, based on the MRV and in Philippine currency.
- In areas with MediCard-Accredited Hospitals
- MediCard shall reimburse one hundred percent (100%) of the approved total hospital bills and of professional fees, based on the MRV
- Ambulance services (land transport)
- Covered on a reimbursement basis
- In cases of non-availability of room according to plan during confinements
- Member may avail of the next higher room available except suite within the first 24 hours of confinement upon admission. All incremental costs incurred after the first 24 hours shall be for the personal account of the member, except when the Accredited Hospital issues a certification of non-availability of the member’s room and board accommodation.
NOTE: MRV – what it would have cost had the service been rendered in an accredited hospital through the services of an accredited doctor
DENTAL CARE
- Oral prophylaxis
- Consultations and oral examinations
- Tooth extractions including surgery for impacted or ankylosed tooth
- Temporary fillings
- Gum treatments for cases like inflammation or bleeding and adjustment of dentures
- Recementation of loose jackets, crowns, in-lays and on-Lay
- Treatment of mouth lesions, wounds and burns
- Emergency out-patient dental treatment
- Temporomandibular Joint (TMJ) consultations
- Restorative and Prosthodontic consultations
- Dental Nutrition & Dietary Counseling
- Dental Health Education
- Prenatal & Postnatal consultations
- Light cure fillings
- Deep scaling
- Root canal
- Dental X-ray
PRE-EXISTING CONDITIONS COVERAGE
Pre-existing conditions are covered for Principal and Dependent Members
NOTE: All other limits mentioned are subject to the Pre-Existing Condition limit, if applicable, based on the given diagnosis
OTHER BENEFITS
- Medical evaluation for enrollees age 41 and above is waived
- Maternity Benefit (Outright coverage)
Type of Delivery | Coverage |
| Caesarean | Up to projected coverage |
| Normal Delivery | |
| D&C (For Miscarriage and Abortion) | |
| Abnormal Pregnancies* | |
| Maternity Complications** | |
| H. Mole/Gestational Trophoblastic Disease (including D&C) |
*Abnormal Pregnancy refers to all pregnancy-related conditions whose onset occurred from conception to puerperium (six weeks after delivery), including pre-delivery availments / confinements. This is an additional limit on top of Manner of Delivery/Termination.
** Maternity Complications refers to all maternity-related conditions whose onset occurred beyond puerperium, including but not limited to incisional hernia, pelvic relaxation, rectocoele, uterine prolapse, etc.
NOTE: All maternity benefits except “Maternity Complications” may be availed ONLY for one (1) pregnancy per contract year.
3. PhilHealth/ECC Provision – It is hereby declared and agreed that hospitalization benefits due under the PHILHEALTH and/or Employee Compensation Commission (ECC) program are assigned to and integrated with the MediCard program such that any of the MediCard benefits due under this Agreement shall be net of the MEMBER’s PHILHEALTH and/or Employee Compensation Commission (ECC) benefits. MediCard will not pay or advance the costs of such benefits, nor be responsible for filing any claims under PHILHEALTH and/or ECC.
MEMBERSHIP ELIGIBILITY
Individual Plan
Principal Member: Any person at least 18 years old up to 99 years of age
Family Plan
Principal Member: Any person at least 18 years old up to 60 years of age
Qualified Dependent Members:
For married Principal Members
- Legal spouse up to age 60
- Legitimate and/or legally adopted children, 30 days old up to 60 years of age who are not gainfully employed and unmarried
For single Principal Members
- Parents up to age 60, unemployed and dependent on the Principal Member
- Brothers and sisters, 30 days old up to 60 years of age, who are not gainfully employed and unmarried
For single parent Principal Members
- Children, 30 days old up to 60 years of age, who are not gainfully employed and unmarried
EXCLUSIONS
A. HOSPITALIZATION
- All confinement shall be upon recommendation of the MEMBER’s MediCard accredited Physician, or the MediCard Medical Director or the Emergency Room Resident Physician of the MediCard Accredited Hospital who decides to admit MediCard patient-MEMBER in cases of life- threatening emergencies.
- Hospital bills for the following hospital services shall be charged to the account of the MediCard patient-MEMBER: services of a private nurse or doctor, use of extra food and/or bed, T.V., electric fan, video/audio disc player, ID bracelet, thermometer and all other items not directly related to the medical management of the patient-MEMBER.
- Hospitalization and treatment outside the Philippines are not covered except where there is a coverage for “Emergency Care Services in Foreign Countries”, explicitly indicated in Article V of Schedule A under this Agreement.
- MediCard is not responsible and will not recognize any hospital bills incurred by a MEMBER in hospitals not accredited by MediCard, except for emergency care services under the terms provided in this Agreement.
- Cost of hospitalization, medical services, medicine and other expenses incurred as a result of a MEMBER’s decision to avail of such hospitalization, medical services, treatment or procedure, not prescribed or contrary to what has been prescribed by the MediCard attending physician, or without MediCard’s express written report shall not be shouldered by MediCard.
B. OUT-PATIENT SERVICES
- Prescribed medicines on an out-patient basis are not provided by MediCard-owned Clinics or Medical Service Units.
- The absolutely no charge out-patient medical and health care services are provided only during clinic hours of Medical Service Units.
- Second opinions and cost of treatment incurred in non-accredited hospital or clinic should the MEMBER unilaterally decide to seek such recourse.
C. LIMITATION IN SERVICES – MediCard is not responsible for the following:
- Delay or failure to render services due to major disasters, brownouts or epidemics affecting facilities or personnel.
- Unusual circumstances such as complete or partial destruction of facilities, war, riots, disability of a significant number of MediCard personnel or similar events which result in delay to provide services.
- Conditions for which a MEMBER has refused recommended treatment for personal reasons, for which MediCard physicians believe no professionally acceptable alternative treatment exists.
- Sudden change of hospital policies.
PRICE LIST
For minimal access fees and a refundable revolving fund, you can avail yourself of MediCard healthcare coverage in any of our accredited providers nationwide.
FOR INDIVIDUALS WITHOUT ACCESS TO 5-STAR HOSPITALS
| AGE | FUND | ANNUAL ACCESS FEE PER MEMBER |
| 60 and below | P30,000 | P3,000 |
| Above 60 | P58,000 | P3,000 |
FOR INDIVIDUALS WITH ACCESS TO 5-STAR HOSPITALS
| AGE | FUND | ANNUAL ACCESS FEE PER MEMBER |
| 60 and below | P45,000 | P3,000 |
| Above 60 | P78,000 | P3,000 |
FOR FAMILIES WITHOUT ACCESS TO 5-STAR HOSPITALS
| AGE | FUND | ANNUAL ACCESS FEE PER MEMBER |
| 2-4 | P55,000 | P3,000 |
| 5 and up | P75,000 | P3,000 |
FOR FAMILIES WITH ACCESS TO 5-STAR HOSPITALS
| AGE | FUND | ANNUAL ACCESS FEE PER MEMBER |
| 2-4 | P75,000 | P3,000 |
| 5 and up | P95,000 | P3,000 |
5-Star Hospitals:
AHMC – Asian Hospital and Medical Center
CSMC – Cardinal Santos Medical Center
MMC – Makati Medical Center
SLMC – Global City – St. Luke’s Medical Center – Global City
SLMC – QC – St. Luke’s Medical Center – Quezon City
TMC – The Medical City
NOTE:
These are the minimum revolving fund sizes recommended for individuals/families with no known pre-existing conditions. For inquiries, please call or email: 8810-0210 / retailproducts@medicardphils.com.
MOA / TERMS AND CONDITIONS
Make sure that you have secured a copy of the Memorandum of Agreement (MOA) for your reference. You can download and/or print a copy of the MOA by clicking the button below.
DESCRIPTION
MediCard Select is an innovative solution that allows members of all ages to avail themselves of healthcare coverage for minimum fees and management of fund. Best of all, members only pay for what is utilized and unused funds shall be returned.
MediCard Select offers a suite of benefits that give members of all ages the coverage they need. Qualified individuals, families or SMEs will receive coverage for hospitalization, outpatient, and preventive healthcare that includes Annual Physical Exam and the following 8 blood chemistries- Fasting Blood Sugar, Total Cholesterol, Uric Acid, Creatinine, BUN, HDL, LDL and Triglycerides.
Moreso, those who are qualified for membership will have emergency and dental benefits. Dental benefits cover tooth extractions, consultations and oral examinations, oral prophylaxis and more.
Rules and limits apply.
Note: Information on this online store is valid until updated.
[Last update: May 15, 2022]
BENEFITS
HOSPITALIZATION BENEFITS
- No deposit upon admission
- Room & Board: Regular Private Open
- Use of operating theatre and Recovery Room
- Services of MediCard specialist like anesthesiologists, internists, surgeons, etc.
- Services and medications for general/spinal anesthesia or other forms of anesthesia deemed necessary for a surgical procedure
- Fresh whole blood transfusions and its processing/screening and intravenous fluids
- X-ray and laboratory examinations
- Administered medicines
- Dressings, plaster casts, sutures, etc.
- ICU confinements
- Chemotherapy
- Radiotherapy
- Dialysis
- Human blood products and its processing/screening including gamma globulin
- Admission kit including wee bag
- Laparoscopic Procedures
- Lithotripsy/ESWL
- Hysteroscopic Procedures
- Stereotactic Brain Biopsy / Stereotactic Breast Biopsy
- Gamma Knife Surgery
- Percutaneous Ultrasonic Nephrolithotomy
- Transurethral Microwave Therapy (TUMT) of the prostate
- Arthroscopically-guided Procedures
- CT Scan / MRI / Ultrasound guided excisions
- Endoscopically-guided excisions / treatments / procedures
- Intradiscal Electrothermal Therapy (IDET)
- Laser/Coblation Tonsillectomy
- Endovenous Laser Therapy/Endovenous Laser Ablation/Radiofrequency Ablation (except for cosmetic purposes)
- Coblation Procedures
- Ductoscopy (Breast) guided excisions/treatment/procedures
- Endoscopic Ultrasound guided excisions/treatment/procedures
- Infrared Coagulation Hemorrhoidectomy
- Mammotome/Vacuum Assisted Breast Biopsy
- Stereotactic Radiation Therapy / Stereotactic Radiosurgery
- Thyroplasty (implant not covered)
- Transarterial Hemorrhoidal Dearterialization (THD)
- Ultroid Hemorrhoid Management
- Any other modern therapeutic procedure not mentioned above
- Magnetic Resonance Imaging (MRI) / Magnetic Resonance Angiography (MRA)
- CT Scan
- Ultrasound
- Robotic Surgery / Robotically-assisted Surgery
- Photodynamic Therapy
- Acoustic Radiation Force
- Capsule Endoscopy
- New diagnostic and treatment procedures for conditions with established etiologies and its use is only as alternative to the conventional methods
- Laboratory/ancillary services for conditions whose pathogenesis or subsequent clinical improvement is not yet fully established in Medical Science
- Other medically necessary modalities not mentioned above and those for which there are no comparable, conventional or traditional counterparts
- Positron Emission Tomography (PET) Scan
- Stapled Hemorrhoidectomy
- Cryosurgery
- Work-related illness/accidents
- Unprovoked/Provoked Assault
- Hyperventilation syndrome
- Congenital Illnesses (regardless of PEC limit)
- Slipped Disc, Scoliosis, Spondylosis, Spinal Stenosis
- Open heart surgery (including cost of stent and pacemaker)
- Organ transplant (including cost of organ and donor’s expense)
- Complex diagnostic examinations and therapeutic procedures
- Professional fee of the assisting physician in surgical procedures
- All other items directly related to the management of the case
- Visitation of MediCard liaison officer
-
OUTPATIENT CARE
- Referral to specialists
- Regular consultations & treatment
- Eye, Ear, Nose & Throat treatment
- Treatment of minor injuries and surgery not requiring confinement
- X-ray and laboratory examinations prescribed by MediCard physician
- Physical Therapy / Speech Therapy
- Laser treatment of Glaucoma & Retinal Detachment
- Cataract Extraction including phacoemulsification and cost of lens
- Cauterization of warts (including facial warts)
- Doses of anti-rabies, anti-venom, anti-tetanus
- Tuberculin Test (including screening)
- Pre & Post-natal consults Covered; including labs
- Sclerotherapy (including cost of sclerosing agent)
- Chronic Dermatoses
- Scabies
- Allergy Testing
- Annual Physical Examination (APE) to include:
- Complete Blood Count
- Urinalysis (urine examination)
- Fecalysis (stool examination)
- Chest X-ray
- Electrocardiogram
- Pap smear
- Eight Blood Chemistries: Fasting Blood Sugar, Total Cholesterol, Uric Acid, Creatinine, BUN, HDL, LDL and Triglycerides – for members 30 years old and above
- Anti-flu vaccines – for members below 30 years old
- Management of health problems
- Routine immunization
- Counselling on health habits, diets and family planning
- Record keeping of medical history
NOTE: APE may be conducted at any MediCard-free standing clinic
EMERGENCY CARE
- Emergency Care in MediCard-Accredited Hospitals/Clinics
- Doctor’s services
- Medicines used during treatment or for immediate relief
- Oxygen and intravenous fluids
- Dressings, plaster casts, and sutures
- Laboratory, X-ray and other diagnostic examinations
- Emergency Care in Non-MediCard Accredited Hospitals: MediCard agrees to reimburse 100% of Approved Hospital Bills and Professional Fees based on MediCard Relative Value (MRV)
- When a member is in immediate danger of losing a limb, eye or other parts of the body or is in severe pain that requires immediate relief and enters a non-MediCard accredited hospital for treatment.
- MediCard shall pay the said amount when it is verified that MediCard facilities were not used because to have done so would entail a delay resulting in death, serious disability or significant jeopardy to the member’s condition or the choice of hospital was beyond the control of the member or the member’s family. Other expenses not covered in using non-MediCard Accredited Hospitals for emergency care is follow up care.
- Emergency Care in Foreign Countries
- MediCard shall reimburse one hundred percent (100%) of the approved total hospital bills and of professional fees, based on the MRV and in Philippine currency.
- In areas with MediCard-Accredited Hospitals
- MediCard shall reimburse one hundred percent (100%) of the approved total hospital bills and of professional fees, based on the MRV
- Ambulance services (land transport)
- Covered on a reimbursement basis
- In cases of non-availability of room according to plan during confinements
- Member may avail of the next higher room available except suite within the first 24 hours of confinement upon admission. All incremental costs incurred after the first 24 hours shall be for the personal account of the member, except when the Accredited Hospital issues a certification of non-availability of the member’s room and board accommodation.
NOTE: MRV – what it would have cost had the service been rendered in an accredited hospital through the services of an accredited doctor
DENTAL CARE
- Oral prophylaxis
- Consultations and oral examinations
- Tooth extractions including surgery for impacted or ankylosed tooth
- Temporary fillings
- Gum treatments for cases like inflammation or bleeding and adjustment of dentures
- Recementation of loose jackets, crowns, in-lays and on-Lay
- Treatment of mouth lesions, wounds and burns
- Emergency out-patient dental treatment
- Temporomandibular Joint (TMJ) consultations
- Restorative and Prosthodontic consultations
- Dental Nutrition & Dietary Counseling
- Dental Health Education
- Prenatal & Postnatal consultations
- Light cure fillings
- Deep scaling
- Root canal
- Dental X-ray
PRE-EXISTING CONDITIONS COVERAGE
Pre-existing conditions are covered for Principal and Dependent Members
NOTE: All other limits mentioned are subject to the Pre-Existing Condition limit, if applicable, based on the given diagnosis
OTHER BENEFITS
- Medical evaluation for enrollees age 41 and above is waived
- Maternity Benefit (Outright coverage)
Type of Delivery | Coverage |
| Caesarean | Up to projected coverage |
| Normal Delivery | |
| D&C (For Miscarriage and Abortion) | |
| Abnormal Pregnancies* | |
| Maternity Complications** | |
| H. Mole/Gestational Trophoblastic Disease (including D&C) |
*Abnormal Pregnancy refers to all pregnancy-related conditions whose onset occurred from conception to puerperium (six weeks after delivery), including pre-delivery availments / confinements. This is an additional limit on top of Manner of Delivery/Termination.
** Maternity Complications refers to all maternity-related conditions whose onset occurred beyond puerperium, including but not limited to incisional hernia, pelvic relaxation, rectocoele, uterine prolapse, etc.
NOTE: All maternity benefits except “Maternity Complications” may be availed ONLY for one (1) pregnancy per contract year.
3. PhilHealth/ECC Provision – It is hereby declared and agreed that hospitalization benefits due under the PHILHEALTH and/or Employee Compensation Commission (ECC) program are assigned to and integrated with the MediCard program such that any of the MediCard benefits due under this Agreement shall be net of the MEMBER’s PHILHEALTH and/or Employee Compensation Commission (ECC) benefits. MediCard will not pay or advance the costs of such benefits, nor be responsible for filing any claims under PHILHEALTH and/or ECC.
MEMBERSHIP ELIGIBILITY
Individual Plan
Principal Member: Any person at least 18 years old up to 99 years of age
Family Plan
Principal Member: Any person at least 18 years old up to 60 years of age
Qualified Dependent Members:
For married Principal Members
- Legal spouse up to age 60
- Legitimate and/or legally adopted children, 30 days old up to 60 years of age who are not gainfully employed and unmarried
For single Principal Members
- Parents up to age 60, unemployed and dependent on the Principal Member
- Brothers and sisters, 30 days old up to 60 years of age, who are not gainfully employed and unmarried
For single parent Principal Members
- Children, 30 days old up to 60 years of age, who are not gainfully employed and unmarried
EXCLUSIONS
A. HOSPITALIZATION
- All confinement shall be upon recommendation of the MEMBER’s MediCard accredited Physician, or the MediCard Medical Director or the Emergency Room Resident Physician of the MediCard Accredited Hospital who decides to admit MediCard patient-MEMBER in cases of life- threatening emergencies.
- Hospital bills for the following hospital services shall be charged to the account of the MediCard patient-MEMBER: services of a private nurse or doctor, use of extra food and/or bed, T.V., electric fan, video/audio disc player, ID bracelet, thermometer and all other items not directly related to the medical management of the patient-MEMBER.
- Hospitalization and treatment outside the Philippines are not covered except where there is a coverage for “Emergency Care Services in Foreign Countries”, explicitly indicated in Article V of Schedule A under this Agreement.
- MediCard is not responsible and will not recognize any hospital bills incurred by a MEMBER in hospitals not accredited by MediCard, except for emergency care services under the terms provided in this Agreement.
- Cost of hospitalization, medical services, medicine and other expenses incurred as a result of a MEMBER’s decision to avail of such hospitalization, medical services, treatment or procedure, not prescribed or contrary to what has been prescribed by the MediCard attending physician, or without MediCard’s express written report shall not be shouldered by MediCard.
B. OUT-PATIENT SERVICES
- Prescribed medicines on an out-patient basis are not provided by MediCard-owned Clinics or Medical Service Units.
- The absolutely no charge out-patient medical and health care services are provided only during clinic hours of Medical Service Units.
- Second opinions and cost of treatment incurred in non-accredited hospital or clinic should the MEMBER unilaterally decide to seek such recourse.
C. LIMITATION IN SERVICES – MediCard is not responsible for the following:
- Delay or failure to render services due to major disasters, brownouts or epidemics affecting facilities or personnel.
- Unusual circumstances such as complete or partial destruction of facilities, war, riots, disability of a significant number of MediCard personnel or similar events which result in delay to provide services.
- Conditions for which a MEMBER has refused recommended treatment for personal reasons, for which MediCard physicians believe no professionally acceptable alternative treatment exists.
- Sudden change of hospital policies.
PRICE LIST
For minimal access fees and a refundable revolving fund, you can avail yourself of MediCard healthcare coverage in any of our accredited providers nationwide.
FOR INDIVIDUALS WITHOUT ACCESS TO 5-STAR HOSPITALS
| AGE | FUND | ANNUAL ACCESS FEE PER MEMBER |
| 60 and below | P30,000 | P3,000 |
| Above 60 | P58,000 | P3,000 |
FOR INDIVIDUALS WITH ACCESS TO 5-STAR HOSPITALS
| AGE | FUND | ANNUAL ACCESS FEE PER MEMBER |
| 60 and below | P45,000 | P3,000 |
| Above 60 | P78,000 | P3,000 |
FOR FAMILIES WITHOUT ACCESS TO 5-STAR HOSPITALS
| AGE | FUND | ANNUAL ACCESS FEE PER MEMBER |
| 2-4 | P55,000 | P3,000 |
| 5 and up | P75,000 | P3,000 |
FOR FAMILIES WITH ACCESS TO 5-STAR HOSPITALS
| AGE | FUND | ANNUAL ACCESS FEE PER MEMBER |
| 2-4 | P75,000 | P3,000 |
| 5 and up | P95,000 | P3,000 |
5-Star Hospitals:
AHMC – Asian Hospital and Medical Center
CSMC – Cardinal Santos Medical Center
MMC – Makati Medical Center
SLMC – Global City – St. Luke’s Medical Center – Global City
SLMC – QC – St. Luke’s Medical Center – Quezon City
TMC – The Medical City
NOTE:
These are the minimum revolving fund sizes recommended for individuals/families with no known pre-existing conditions. For inquiries, please call or email: 8810-0210 / retailproducts@medicardphils.com.
MOA / TERMS AND CONDITIONS
Make sure that you have secured a copy of the Memorandum of Agreement (MOA) for your reference. You can download and/or print a copy of the MOA by clicking the button below.
