My Maxicare Lite Plan 1599

1,599.00

For 2 years old up to 60 years old.

One-time availment up to Php25,000 of In-Patient services (for confirmed cases of the identified coverable diseases) to all Maxicare affiliated hospitals EXCLUDING access to 6 major hospitals – Asian Hospital, Makati Medical Center, Cardinal Santos Medical Center, St Luke’s BGC, St. Luke’s QC and The Medical City.

Description

PRODUCT FEATURES

 

  • One-time availment up to Php25,000 for In-Patient services for confirmed cases of the identified coverable diseases
  • Easy registration via SMS. No preliminary check-up, no paperwork needed.
  • One-time availment only
  • Membership valid for 1 (one) year upon registration
  • Eligible for individuals two (2) to 60 years old
  • Nationwide ER access to Maxicare-affiliated hospitals (EXCLUDING access to 6 major hospitals – Asian Hospital, Makati Medical Center, Cardinal Santos Medical Center, St Luke’s BGC, St. Luke’s QC and The Medical City)
  • 20% discount from Metro Dental Services. (www.metrodental.com.ph)
  • 15% discount from MyHealth Services. (www.myhealth.ph)

 

 

COVERABLE DISEASES

 

  • Dengue
  • Chikungunya
  • Malaria
  • Typhoid and Paratyphoid
  • Cholera
  • Gastroenteritis
  • Leptospirosis
  • Pneumonia

 

 

PRODUCT COVERAGE

 

  • Room and Board Accommodation (Regular Private)
  • Use of Operating Room, Intensive Care Unit (ICU), Isolation Room  (If prescribed by Attending Accredited Physician) and Recovery Room
  • Professional Fees of Attending Accredited Physician in accordance with Maxicare’s Schedule of Rates
  • Standard nursing services
  • Medicines for in-patient use
  • Blood and by-products for transfusions and intravenous fluids, including blood screening and cross matching for member and only as recipient
  • X-ray laboratory examinations, routine, diagnostic and therapeutic procedures incidental to confinement
  • Oxygen and its administration
  • Standard Admission Kit
  • All other items directly related to the medical management of the patient, as deemed medically necessary by the Maxicare-accredited attending physician
  • Screening tests done are not covered if member is confirmed negative of the coverable diseases.

 

 

AVAILMENT PROCEDURES

 

  • Member goes to any Maxicare accredited accredited hospital according to network access and presents his/her MyMaxicare LITE repaid card together with a valid government/company/ school-issued ID/ birth certificate for children not yet going to school.
  • Maxicare Accredited Hospital will swipe the MyMaxicare LITE prepaid card at POS terminal to generate Letter of Eligibility (LOE) in order to check if card is valid. LOE generation does not guarantee automatic coverage.
  • Maxicare shall issue Letter of Authorization (LOA) only if the final diagnosis is confirmed to be any of the coverable diseases.
  • Automatic cancellation of the membership in the system shall be triggered by LOA issuance.

 

 

IMPORTANT NOTES

 

  • Card will be activated fifteen (15) days after successful SMS registration
  • Card should be activated on or before the validity date printed on the sticker at the back of the kit.
  • Membership is valid for one (1) year from activation date.
  • Coverage starts on the first day of the confinement if confirmed positive of any of the coverable diseases only.
  • If there are multiple diagnoses, coverage is limited to the eight (8) coverable diseases only.
  • If diagnosis did not fall under the eight (8) coverable diseases and LOA is not issued, the MyMaxicare LITE card remains active for future use until the card expires.
  • For one-time availment only.
  • Member may renew one year after the activation date.
  • To report a lost card, please call 582-1900 or 798-7777

 

 

OTHER TERMS & CONDITIONS

 

  • Card will be activated fifteen (15) days after successful SMS registration. Confinement due to the identified diseases that started prior to the card activation shall not be covered.
  • Filing of Philhealth is optional.
  • Reimbursement up to 100% based on Maxicare standard rates of hospital bill and professional fees, subject to the Php 25,000 medical benefit limit, shall be applicable to the  following cases only:

a. Availment with non-accredited attending physician in an accredited hospital.

b. Availment if the accredited hospital did not accept LOA upon confirmation of any of the  eight  (8) coverable diseases.

  • For further information, please visit www.maxicare.com.ph

 

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