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MAXICARE CUSTOMER CHARTER

 

We, at Maxicare Healthcare Corporation (“Maxicare”), the country’s leading health maintenance organization (HMO), are committed to providing access to convenient and reliable health solutions that enable every Filipino to live their best lives.

 

To assure that you are adequately protected and to help guide you through Maxicare’s various products and services, we formulated this Customer Charter.

 

I. Maxicare Products

 

A. Corporate Products 

 

1. Full HMO Program

 

Consists of a comprehensive set of healthcare benefits which include In-Patient, Out-Patient, Preventive Care and Annual Check-Up services subject to certain exclusions, limitations and conditions.

 

2. In-patient (IP) Unbundled

 

A program consisting of the standard IP benefits under the Full HMO product plus Out-Patient (OP) surgery, OP radiotherapy, OP chemotherapy, OP dialysis, preventive care and emergency treatment that may or may not lead to confinement.

 

3. Out-patient (OP) Unbundled

 

A program consisting of the standard OP benefits under the Full HMO product, including preventive and OP emergency cases minus the OP benefits made part of the Unbundled IP.

 

4. Full Risk Program

 

A type of program where payment of membership fees per member is required.

 

5. Full Risk Co-Pay Program

 

A premium-based program arrangement wherein a client can pre-determine a specialized set of benefits.

 

6. Administrative Services Only (ASO)

 

A third party administration program wherein a client can set up and maintain a revolving fund from which the availment cost will be drawn out.

 

You may access this link for more information.

 

https://www.maxicare.com.ph/healthcare-program-for-my-organization/for-corporate/

 

B. Small Medium Enterprise (SME) Products

 

1. MaxicarePlus

 

A full HMO product with standard, non-customizable benefits designed for small and medium enterprises with a minimum of 10 principals and maximum of 99 enrollees, including qualified dependents.

 

2. Maxicare Starter Plan

 

Complete quality healthcare coverage for starting enterprises with minimum principal of 5 and not more than 99 enrollees, including qualified dependents.

 

3. Maxicare Business Essentials

 

The most affordable SME healthcare plan with an out-patient care program only. It can be upgraded to a full HMO program for a minimum of 3 employees up to 99 enrollees.

 

You can always be assured that a Maxicare SME Healthcare Plan is a great business plan.

 

You may access this link for more information.

 

https://www.maxicare.com.ph/healthcare-program-for-my-organization/

 

C. MyMaxicare

 

MyMaxicare is a full coverage HMO plan for individuals and families. With this plan, one is ensured Maximum Care, Minimum Worry.

 

You may access this link for more information.

 

https://www.maxicare.com.ph/healthcare-program-for-me-and-my-family/my-maxicare/

 

D. Prepaid Products

 

Prepaid products are one-time payment and self-registration health care products. Maxicare has four different brands under this category:

 

1. EReady is a one-time use prepaid emergency health card for outpatient emergency care for up to P15,000. Dahil ‘pag aksidente, sagot ka ng EReady!

 

2. EReady Advance is a one-time use prepaid emergency health card that includes confinement with up to P50,000 coverage. Sa panahon ngayon, dapat EReady Advance mag-isip!

 

3. Prima Gold is an affordable health card for senior citizens 60 years old and up. With Prima Gold, it’s #TimeToGiveBack to your senior loved ones.

 

4. Prima Silver is an affordable prepaid health card for individuals 0 to 59 years old. With Prima Silver, give your family #LoveFromTheStart

 

You may access this link for more information.

 

https://shop.maxicare.com.ph/

 

II. Maxicare Services

 

A. Maxicare Telemedicine

 

1. Maxicare Telemedicine 24/7 Teleconsult Voice Call

 

This is a service where members/patients can do phone consultations with physicians anytime, anywhere.

 

2. Maxicare Telemedicine Videoconsult

 

This is a service where members/patients can do video consultations with physicians via video call done through the Doctor Anywhere mobile app.

 

B. Maxicare Wellness app

 

Aktivo is an all-in-one mobile app that guides and helps one to stay active, eat smarter and healthier, and keep track of overall health and wellness.

 

C. Maxicare Primary Care Center (PCC)

 

These centers are wholly-owned and operated by Maxicare, and are well-appointed to give members access to quality healthcare close enough to where they work or live. Each center has its staff of Customer Service Associates, Primary Care Physicians, who are consultants specializing in Internal Medicine and Pediatrics, and additional services like Laboratory and ECG. Each Maxicare PCC provides you with a relaxing healthcare experience.

 

You may access this link for more information.

 

https://www.maxicare.com.ph/contact-us/primary-care-center-and-helpdesk/

 

D. Member Gateway

 

If you are a Maxicare Member, you can conveniently access your healthcare benefits via Maxicare Member Gateway.

 

https://membergateway.maxicare.com.ph/MGLogin.aspx?ReturnUrl=%2f

 

III. Your interactions with Maxicare’s website at maxicare.com.ph

 

Your access to Maxicare’s website is regulated by Maxicare’s Privacy Policy, Data Privacy and Security Arrangements and the Terms and Conditions.

 

We strongly advise that you read through the policies cited above to know more about how we collect, process and disclose your personal data. Rest assured that we are committed to protecting the privacy of our clients and website visitors.

 

We will likewise endeavor to maintain your access to maxicare.com.ph 24/7. However, due to the volatile nature of the internet, your access to the website may be impaired, interrupted, or limited. As such, we cannot guarantee that your interactions with the website will be completely seamless. We likewise conduct routine maintenance and upkeep of the website which may also affect your browsing experience. We will strive to provide you notice ahead of time in the event of any maintenance or provide you a timeline when the website will be back online.

 

IV. Commitment to safe and secure operations

 

We want to provide a safe and secure browsing experience on our website. To ensure this, we have developed several layers of protection so that your data will remain secured and protected. We likewise employ industry standard levels of encryption in all the data you provide to us. We also ensure that our partners have in place the same level of physical, organizational, and technical security measures.

 

To know more on how we do this, you may visit our Privacy Policy and Data Privacy and Security Arrangements.

 

V. Maintenance of customer privacy

 

We value your online privacy and the trust you repose to us when you give your personal information in this website or through other platforms of Maxicare. We ensure that our handling of your personal information is compliant with Republic Act No. 10173 otherwise known as the Data Privacy Act of 2012, including its Implementing Rules and Regulations.

 

Our collection, processing and disclosure of your personal information is regulated by our Privacy Policy or the pertinent Terms and Conditions for the specific Maxicare Product or Service.

 

VI. Quality of Services

 

As the top HMO in the Philippines, we continuously aim to provide comprehensive healthcare programs through a wide network of healthcare providers and enhanced customer support.

 

All the healthcare providers affiliated with Maxicare are properly screened and vetted to maintain the quality of services that Maxicare committed to provide to you. Our customer service hotlines are available 24/7 to assist you in your queries regarding your plan and medical availments. We likewise offer products and services geared towards preventing healthcare mishaps and managing your present condition.

 

VII. Customer Care and Complaints Management

 

A. Our Customer Service Channels

 

1. Our 24×7 Contact Center:

 

+ 632 7798 7770 (Product Inquiry Hotline)

 

+ 632 8582 1900 (PLDT)

 

+ 632 7798 7777 (GLOBE)

 

2. Our customer email support:

 

For inquiries and other concerns, email us at customercare@maxicare.com.ph

 

For general inquiries and other concerns, please expect a response within 24-48 hours. For complaints, please expect an acknowledgment via email or call within 24 hours.

 

B. Acknowledgment of concern/complaint

 

Concerns or complaints filed through our customer service channels are acknowledged, logged, monitored, and resolved by our dedicated teams.

 

1. Email: You will receive an acknowledgement from customercare@maxicare.com.ph within 24-48 hours.

 

2. Contact Center: Our Agents are provided with resources, and are able to provide the information and services that you need.

 

C. Complaint resolution

 

Maxicare seeks to provide you with peace of mind and the best customer experience. Your feedback helps a lot as we aim to continuously improve our products and services.

 

Our Complaints Management and Investigation Team has been established to understand your concerns and provide the most appropriate solutions. We also aim to provide swift assistance to immediately address issues. The team is committed to being responsive, objective and solutions-oriented.

 

Our Team will communicate with you to acknowledge your complaint within 24 hours and shall provide you with a transaction or ticket number for reference.

 

Simple cases shall be resolved within 2 days, while complex complaints requiring further investigation and validation shall be resolved within 3 days. You will receive calls and emails from time to time to update you of the status of your complaint.

 

D. Complaint escalation

 

The Insurance Commission provides assistance to HMO customers and members in resolving disputes and complaints relating HMO products and services. You may reach the Insurance Commission through the contact information available on their website at https://www.insurance.gov.ph/.

 

 

CONNECT WITH US

Product Inquiry Hotline

+632 7798 7770

24/7 Customer Care Hotline
+ 632 8582 1900 (PLDT)

+ 632 7798 7777 (GLOBE)

 
24/7 Customer Care Email
customercare@maxicare.com.ph
 
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