Maxicare Healthcare Insurance

Maxicare Healthcare Corporation

Premium quality healthcare is deserved by every individual. MAXICARE, an industry leader with 20 years of solid healthcare expertise, has been a trusted name among top corporations and individuals.

Maxicare features excellent value to its clients with its : 

• 24-hour customer care call center
• Personalized service for confined members
• Strategically located on-line customer care centers nationwide
• Quality service by the who's who in the medical profession
• Extensive providers' network of hospitals & doctors nationwide
• Delivers commitment of premium quality healthcare

Find out why Maxicare is No.1 in the HMO industry. 

Complete details and benefits below:

For the past 20 years, Maxicare has provided the most comprehensive healthcare benefits through its wide network of medical providers nationwide composed of 10,500 affiliated specialists and more than 541 hospitals and clinics nationwide and excellent delivery system through superior customer service, highlighted by a 24/7 call center to attend to its members' healthcare needs through our brand of premium healthcare. 

Detailed benefits as follows:

I. OUT PATIENT

• Any number of medically necessary consultations during regular clinic hours, except medicines
• Eye, ear, nose and throat (EENT) treatment
• Treatment of minor injuries, such as lacerations, mild burns, sprains, and the like
• X-ray, laboratory examinations, routine, diagnostic and therapeutic procedures such as Chemotherapy, Dialysis, etc., prescribed by an accredited doctor
• Minor surgery not requiring confinement
• Phyisical Therapy up to P1,200./member/year
• Laser Therapy up to P1.200./member/year
• Cauterization of Warts up to P1,000/member/year
• Laparoscopy and Lithotripsy covered up to 100% of the actual cost

II. IN PATIENT

• Room and Board Accomodation
• Use of Operating and Recovery Rooms
• Use of Intensive Care Unit (ICU)
• Professional Fees of attending doctor(s)
• Whole blood and human blood products and IV fluids
• X-ray, laboratory examinations and diagnostic tests
• Dressings, casts and sutures
• Anesthesia and its administration
• Oxygen and its administration
• Laparoscopy and Lithotripsy coveed up to 100% of the actual cost
• Standard nursing/resident doctors’ services
• Admission kit including ice cap and wee bag
• Other supplies directly related to the medical management of the patient

III. SALIENT FEATURES

R&B – Room and Board Accommodation (room category as charged)

MBL – Maximum Benefit Limit (benefit per illness per year)

IV. PREVENTIVE CARE

• Passive and active vaccines for treatment of animal bites, snake bites & tetanus up to Php 18,000 per member per year
• Periodic monitoring of health problems
• Health education and counseling on diets and exercise
• Health habits & family planning counseling
• Wellness Programs

V. ANNUAL CHECK-UP

Platinum Plus Plan: (Multi – Phasic B)

• CBC (Complete Blood Count
• Blood Chemistry (FBS, HDL, Cholesterol, Creatinine, Albumin, Uric Acid, Alkaline Phosphatase, Potassium, LDL, Triglycerides, SGOT, Globulin, Calcium Phosphatase, Urea, Total Cholesterol, VLDL, BUN, SGPT, Total Protein, Total Bilirubin)
• Thyroid Function: TSH-IRMA
• Hepatitis Screening: HbsAg, Anti-HBs, Anti-HBc
• Routine Urinalysis
• Routine Fecalysis including stool for occult blood
• Cardial Work-up (12- Lead ECG, Treadmill Stress Test)
• Chest X-ray
• Abdominal Work-up (Upper Gastrointestinal series, Ultrasound of liver, Gallbladder & Pancreas, Barium Enema, Proctosigmoidoscopy
• Consultations: Gastroenterologist, Cardiologist, Gynecologist/ Urologist
• Consultations without additional cost if deemed necessary by the attending physician (choose 3): Dentistry, Surgery, Psychiatry, Neurology, Hematology, Cardiology, Pulmonology, Nephrology, Otorhinolaryngology, Rheumatology, Infectious/ Tropical, Orthopedics

Platinum Plan: (Executive Check-up)

• Physical Examination
• Urinalysis
• Fecalysis
• Chest X-ray
• CBC (Complete Blood Count)
• Blood Chemistry (Potassium, BUN, Ceatinine, Total Protein, SGPT, Total Bilirubin, Trigycerides, Calcium, Uric Acid, Albumin, SGOT, Alkaline, FBS, HDL, Cholesterol, Phosphate)
• 12 – lead ECG
• Pap Smear
• Ultrasound of the Gallbladder
• Treadmill Stress Test

Gold Plan: (Semi Multi – Phasic C)

• Physical Examination
• Urinalysis
• Fecalysis
• Chest X-ray
• CBC (Complete Blood Count)
• Blood Chemistry (FBS, SGPT, Cholesterol, Creatinine, Uric Acid)
• 12 – Lead ECG
• Pap Smear

Silver Plan: (Routine)

• Physical Examination
• Urinalysis
• Fecalysis
• Chest X-ray
• CBC (Complete Blood Count)
• 12 – Lead ECG
• Pap Smear

VI. EMERGENCY CARE

1. Accredited Hospital

• Doctor’s services
• Emergency Room Fees
• Medicines used for immediate relief and during treatment
• Oxygen, intravenous fluids, whole blood and human blood products
• Dressings, casts and sutures
• X-rays, laboratory and diagnostic examinations and other medical services related to the medical management of the patient

1. Non-accredited hospital

·      Maxicare shall reimburse 80% of the total hospital bills and 50% of the professional fees based on Maxicare’s rates up to Php 20,000.

VII. DENTAL CARE (OPTIONAL)

·      Annual Oral/Dental Examination and Consultation

·      Emergency Dental Treatment

·      Annual Oral Prophylaxis

·      Simple tooth extractions

·      Restorative and Prosthodontic Treatment Planning

·      Permanent fillings up to 2 fillings/year

·      Unlimited temporary fillings, as needed

·      Desensitization of hypersensitive teeth – 2 per year

·      Simple adjustment of dentures

·      Recementation of loose crowns, Inlays or Onlays

·      Dental Nutrition & dietary counseling

·      Dental Health Education

Note: Dental Benefit is optional for an additional fee of P650/person/year

VIII. VALUE ADDED SERVICES

Maxicare’s International Emergency Assist

Maxicare has partnered with International SOS, the world’s largest medical and emergency assistance company, to give you Maxicare International Assist Program. It gives you worldwide access to 24-hour expert advice and assistance – whether it’s help you need to prepare you for your travels or emergency advice and medical care while abroad.

Medical Assistance

• 24-Hour Telephone Medical Advice
• Emergency Medical Evacuation
• Emergency Medical Repatriation
• Repatriation of Mortal Remains
• Hospital Referral, arrangement of admission and Guarantee of Medical Expenses
• Monitoring of Medical Condition
• Delivery of Essential Medicine
• Discounted Hospitalization Expenses in the United States

Travel Assistance

• Pre-trip Information Services
• Embassy / Legal / Interpreter Referrals
• Lost luggage and Passport Assistance
• Emergency Message Transmission or Document Delivery Assistance

With all these benefits and with 500+ and counting accredited hospitals and clinics all over the country, Maxicare is the premier health card of choice by most companies and individuals.

For details, inquiries, concerns, or if you want to learn about Maxicare's extensive network of hospitals, contact 

PAJ Resources at 8932285 or 8938790 

Telefax: 8935334. Office hours: Monday to Friday, 8AM to 4:30PM

E-mail: paj546@hotmail.com

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