Benefits and Coverage
Explore exclusive benefits and personalized services. Maxicare offers members a variety of quality inpatient and outpatient services for easy access to the care they need to live their best lives.
Inpatient care
- Room and board accommodation
- Use of Operating Room, Intensive Care Unit (ICU), Isolation Room and Recovery Room
- Professional fees of attending physicians, surgeons, anesthesiologist and Cardio-pulmonary Specialist (for clearance before surgery and cardiac monitoring during surgery)
- Standard nursing services
- Medicines for inpatient care
- Blood product transfusions and intravenous (IV) fluids
- X-ray, laboratory examinations, diagnostic tests and therapeutic procedures incidental to confinement
- Dressings, conventional casts (plaster of Paris) and sutures
Outpatient care
- X-ray, laboratory examinations, routine, diagnostic and therapeutic procedures
- Consultations
- Treatment of minor injuries
- Minor surgery not requiring confinement
- Eye laser therapy for retinal tear / hole / detachment and glaucoma
- Cauterization of warts
- Sclerotherapy (for varicose veins)
- Speech therapy (For stroke patients only)
- Allergy testing
- Tuberculin test
Preventive care
Passive and active vaccines for treatment of tetanus and animal bites
Emergency care
Any life-threatening or unexpected onset of a condition or illness, which requires the immediate alleviation of pain or discomfort within 24 hours including confinement in a regular private room.
Affiliated Hospital
- Doctor’s services
- Consultations
- Emergency room fees
- Medicines used for immediate relief and during treatment
- Oxygen, intravenous (IV) fluids and blood products
- Dressings, conventional casts (plaster of Paris) and sutures
- X-rays, laboratory, diagnostic examinations and other medical services related to the emergency treatment of the patient
Non-Affiliated Hospital
Within the Philippines
- Reimbursement up to 80% of the actual hospital bills and 80% of the Professional fees (based on Maxicare rates) incurred during the first twenty-four (24) hours of treatment up to ₱30,000.00 / availment / member.
Areas without accredited hospitals within the Philippines
- Reimbursement of 100% of the total hospital bills and Professional fees (based on Maxicare rates)
Outside the Philippines
- Maxicare shall reimburse 100% actual costs up to ₱30,000.00 / availment / member
Ambulance Service up to ₱2,500.00 per conduction
Additional benefits
- Life coverage with Accidental Death & Dismemberment
- Scoliosis treatment
- Congenital illness
- Consultations for Chronic Dermatoses up to Benefit Limit
- Transurethral Microwave Therapy of Prostate
Annual Check-Up (ACU) - Available to all plan types
Clinic-based Annual Check-Up, consist of five (5) basic routines:
- History and physical exam
- CBC (Complete Blood Count)
- Routine Urinalysis
- Routine Fecalysis
- Chest x-ray (PA and lateral)
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
- Unlimited temporary fillings, as needed
- Desensitization of hypersensitive teeth twice a year
- Simple adjustment of dentures
- Recementation of loose crowns, inlays or onlays
- Dental nutrition and Dietary counseling
- Dental Health Education
Maxicare’s international assist program
- 24-hour Telephone Medical Advice
- Emergency Medical Evacuation
- Emergency Medical Repatrition
- Repatrition of Mortal Remains
This is in partnership with Assist America. Visit their website www.assistamerica.com for more information
Dreaded disease / condition
This corresponds to any condition that is considered to be chronic, progressive, life-threatening and which may entail lifelong therapy. This also refers to conditions where complete cure cannot be ensured.