Terms and Conditions


Simply visit any of our MediCard free standing clinics, present your card with one valid ID and avail of our services. You may also apply online.



The following are the benefits and coverages included in the RxER:

(All others not mentioned are not included under the RxER health plan)



Annual Physical Exam (at any MediCard free standing clinics and UROIC)

– Complete Blood Count

– Chest X-ray

– Urinalysis

– General Check-up

– Fecalysis



The following Out-Patient Services will be provided to members in any MediCard free standing clinics and UROIC:

– free unlimited consults with primary care physicians (General Practitioners and Family Medicine physicians), Pediatricians, Medical Internists and Ob-gynecologists (except maternity-related consultations. Flat rate of php350 applies.)

– php 350 for consultations with other specialists and sub-specialists

– 30% discount on laboratory and diagnostic tests

– 30% discount on surgeries and other services

– 30% discount on procedures at the Skin Care Clinic



Members may avail of the following dental services at our MediCard free standing clinics:

– free one time oral prophylaxis

– 30% discount on dental procedures

– free dental consultations


Some services may not be available in some MediCard free standing clinics.

Please call your preferred branch to verify.



(A) MediCard will cover only the following emergency cases availed at all MediCard accredited hospitals provided that it is within six (6) hours from the time of incident and subject to the conditions under exclusion


– i.e. vehicular accidents and other forms of accidents not brought about by the member’s own negligence or misconduct or not brought about by acts which are against the law of the Philippines.

– For vehicular accidents, vehicle registration (OR/CR) and driver’s license should be submitted.





(B) MediCard will give a total limit of php 20,000. Member may avail of the emergency services more than once as long as there is still remaining limit.

* Emergency care charges include the following subject to the total emergency care limit:

– Doctor’s services

– Emergency Medicines used during treatment or for immediate relief

– Oxygen

– Dressings, ordinary casts, and sutures

– tetanus toxoid, anti-tetanus serum, and active immunization for rabies

– basic laboratory, x-ray and other  basic diagnostic examinations directly related to the emergency management of the patient.

– CT scan, MRI and ultrasound are covered up to P5,000 each if deemed necessary for the immediate management of the patient.

– Emergency Complex Diagnostic and Therapeutic Procedures will be covered by MediCard up to P5,000.

– The following are considered as complex diagnostic or therapeutic procedures:

I.         angiography

II.       pulmonary perfusion scan

III.     tests involving use of nuclear technologies

IV.      electromyography, nerve conduction studies

V.         2D echo and Doppler

VI.       endoscopies including one of video

VII.     arthroscopies

VIII.    adrenocortical functions

IX.        all other diagnostic tests and therapeutic procedures not mentioned but deemed by MediCard as a complex diagnostic and therapeutic procedure



– MediCard will cover hospital charges at non-MediCard accredited hospitals subject to the emergency care benefits mentioned. This will be on a reimbursement basis



MediCard will give assistance up to P50,000   based on the following cases below for accidental death and injury provided that the death or injury results from causes that are covered under Emergency Benefits.  Causes of death or injury should also not be under the list of exclusions, a pre-existing condition nor a dreaded disease.

– 100% for LOSS of either of the ff: life, both hands or both feet, both arms or both legs, sight of both eyes, one hand AND one foot, hearing  on both ears, speech or any other injury causing permanent disablement.

– 75% for LOSS of one arm OR one leg

– 50% for LOSS of either of the ff: one hand or foot or sight of one eye, four fingers of one hand, or one foot above the ankle

– 25% for LOSS of thumb AND index finger of either hand or ALL toes of one foot

– 15% for LOSS of two fingers of any one hand

– 5% for LOSS of one big toe



It is expressly agreed that the MEMBER shall abide by such reasonable rules and regulations concerning the Health Care Program that may be issued by MediCard in the interest of improving the over-all efficiency and effectiveness of the delivery of all the medical benefits under this material to all MediCardRxER MEMBERS.

This RxER coverage is non-transferable.



MediCard emergency care services are extended to a member if the member’s bodily injuries and fractures are claimed to have been caused by any act or omission of a third party through a motor vehicle. Provided, however, that the member executes an agreement to subrogate to MediCard whatever rights the member may have by reason of such accident or event that gave rise to such claim to the extent of the value of the services so rendered. The agreement to subrogate form is available at MediCard Head Office. MediCard’s liability hereunder shall also be subject to the exclusions stated.






(a) Prescribed medicines

(b) All other forms of services not provided under membership benefits and privileges



(a) Hospitalization and treatment outside the Philippines are not covered.

(b) Cost of  medical services, medicine and other expenses incurred  as a result of a member’s decision to avail of such  medical services, treatment or procedure, not prescribed or contrary to what has been prescribed by the attending MediCard provider, or without MediCard’s express written report shall not be covered by MediCard.

(c) All other cases not specifically mentioned under Emergency Care Benefits  will not be covered by MediCard.

(d) Plastic and reconstructive surgery for cosmetic purposes and for physical congenital deformities and abnormalities.

(e) Slipped disc, herniated disc, scoliosis, spinal stenosis and spondylosis.

(f) Experimental medical procedures, acupuncture, acupressure, reflexology and chiropractics.

(g) Purchase or lease of durable medical equipment, oxygen dispensing equipment and other medical supplies.

(h) Corrective appliances, artificial aids and prosthetic devices.

(i) Human blood products like platelets, packed RBC, plasma, gamma globulin, etc. and its processing.

(j) Psychiatric and psychological illnesses including neurotic and psychotic behavior disorders.

(k) Treatment for alcoholic intoxication and drug addiction or overdose reaction to use of prohibited drugs including illnesses directly related to it and other injuries attributed as a result of it.

(l) Rehabilitation treatment and physical therapies.

(m) Hazardous job-related illnesses and/or injuries.

(n) Injuries or illnesses resulting from participation in war-like or combat operations, riots, insurrection, rebellion, strikes, domestic violence and other civil disturbances.

(o) Treatment of self-inflicted injuries or injuries attributable to the MEMBER’S own misconduct, gross negligence, use of alcohol and/or drugs, vicious or immoral habits, participation in act of crime, violation of a law or ordinance, unnecessary exposure to imminent danger or hazard to health, combat sports and sparring such as tae kwan do, boxing, muaithai , sports injuries without the use of proper equipment and hazardous sports related injuries.

(p) Oral surgery or (TMJ) surgery done by dental practitioner.

(q) Treatment of injuries sustained in a motor vehicle accident if the member or his guardian fails or refuses to execute the deed of Subrogation

(r) Professional fees of medico-legal officers.

(s) Cost of vaccines for active and passive immunization including passive immunization or immunoglobulin for rabies.

(t) All other services not specifically mentioned under Emergency Care Services.


LIMITATION OF SERVICES – MediCard is not responsible for the following:

(a) Delay or failure to render services due to major disasters, brownouts or epidemics affecting facilities or personnel.

(b) 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.

(c) Conditions for which a member has refused recommended treatment for personal reasons, for which MediCard physicians believe no professionally acceptable alternative treatment exists.

(d) Sudden change of hospital policies.

(e) Failure of the patient to get the proper treatment if deemed not covered by MediCard



(a) The member shall not use the benefits of his other MediCard coverage (if any) simultaneously with the RxER package or vice versa.

(b) The member shall only use his RxER one at a time.



This health plan may be pre-terminated by MediCard and the membership fees paid by the MEMBER shall be forfeited in favor of MediCard if the MEMBER:

(a) Fails to maintain a satisfactory hospital-patient or doctor-patient relationship with the Designated Physician, the Medical Service Units/Teams, Designated Hospital with Accredited Hospital.

(b) Knowingly furnishes MediCard incorrect or incomplete enrollment information.

(c) Permits the use of his/her membership by another person.


In all cases of pre-termination, MediCard shall send appropriate notice of the existence of the ground for pre-termination to the MEMBER and allow the MEMBER to explain his/her side. Termination shall take effect upon final notice sent to the MEMBER at his/her address of record.


RxER is not a full HMO plan.