What is the availment procedure for emergency cases?
IN MEDICARD-ACCREDITED HOSPITALS:
- Proceed to the emergency room of any MediCard-accredited hospital.
- Present your MediCard ID.
- If you have been advised by the ER doctor to undergo any laboratory/diagnostic test or ER procedure, a hospital staff will secure an approval from MediCard.
- In case you have been advised for admission, the ER doctor will admit you under the services of the MediCard Coordinator.
IN NON-MEDICARD ACCREDITED HOSPITALS:
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.
