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I availed myself of services from a non-accredited hospital for an ER case, is that alright?
For emergency medical services in non-MediCard accredited medical facilities, members must first settle all payments and later file reimbursement from MediCard. MediCard shall reimburse eighty percent (80%) of the total bills, inclusive of professional fees, based on what would have been the cost had the service been rendered in an accredited hospital through the services of an accredited doctor, but not to exceed the amount of P30,000.
MediCard shall reimburse members for the medical services in non-accredited hospitals 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.