INDIVIDUAL & •

•
Anesthesia and its administration
Oxygen and its administration
•
•
Physical Examination
Urinalysis
FAMILY • Laparoscopy and Lithotripsy covered up to 100% of the actual
cost
•
•
Fecalysis
Chest X-ray
HEALTHCARE •
•
Standard nursing services
Admission kit including ice cap and wee bag
• CBC (Complete Blood Count)
• 12 – Lead Elecrocardiogram (exclusive for 35 years old & above as
PROGRAM • Other supplies directly related to the medical management of the
patient an optional package)
• Papsmear (exclusive for 35 years old & above as an optional
III. ANNUAL CHECK UP package)
PLAN TYPE ROOM & MAXIMUM ANNUAL CHECK UP * according to plan of choice
BOARD BENEFIT IV. PREVENTIVE CARE
LIMIT Platinum Plus Plan: (Multi-Phasic B) • Coverage for Passive & Active vaccine for anti-tetanus & anti-
Platinum Large 200,000 Overnight Executive • CBC (Complete Blood Count) rabies up to P18, 000/member/year (for animal bites)
Plus Private Check UP • Blood Chemistry (FBS, HDL, Cholesterol, Creatine, Albumin, Uric • Periodic monitoring of health problems
Platinum Regular 150,000 Executive Check Up Acid, Alkaline Phosphatase, Potassium, LDL, triglycerides, SGOT, • Health education & counseling on diets or exercise
Private Globulin, Calcium Phosphatase, Urea, Total Cholesterol, VLDL, SGPT,
• Family planning counseling
Gold Regular 100,000 Semi Executive Check Total Protein, Total Billrubin)
Private Up • Thyroid Function:TSH-IRMA V. EMERGENCY CARE
Silver Semi Private 60,000 Routine/Basic • Hepatitis Screening: BhsAg, Anti-HBs, Anti-HBc
• Routine Urinalysis A. ACCREDITED HOSPITAL
1. Age eligibility is 2-60 years old renewable up to 65 years old • Routine Fecalysis
2. Access to any accredited hospital and clinic nationwide • Doctor’s services
• Cardiac Work-up (12-Lead ECG, Treadmill Stress Test) • Emergency room fees
I. OUTPATIENT CARE
• Chest x-ray • Medicines used for immediate relief & during treatment
• Medically necessary consultations during regular clinic hours, • Abdominal Work-up (Upper Gastrointestinal series, Ultrasound of • Oxygen, intravenous fluids, whole blood & human blood
except medicines. liver, Gallbladder & Pancreas, barium Enema, Proctosigmoidoscopy) products
• Dermatology Consultations • Dressings, casts & sutures
• Eye, ear, nose and throat (EENT) treatment Platinum Plan : (Executive Check-up)
• X-rays, laboratory & diagnostic examinations & other medical
• Physical Examination
• Treatment of minor injuries such as lacerations, mild burns, • Urinalysis
services related to the emergency treatment of the patient.
• Ambulance Service for accredited hospital-to-hospital
sprains and the like • Fecalysis transfer up to P 2,500./ per conduction (by reimbursement)
• X-ray, laboratory examinations, routine, diagnostic and • Chest X-ray
therapeutic procedures prescribed by an accredited doctor • CBC (Complete Blood Count) B. NON-ACCREDITED HOSPITAL
• Minor surgery not requiring confinement • Blood Chemistry – Potassium, Creatinine, Total Protein, Total • Maxicare shall reimburse 80% of the total hospital bills and
• Physical Therapy/Occupational Therapy up to 12 (twelve) sessions Bilirubin, Triglycerides, Calcium, Uric Acid, Albumin, SGOT, Alkaline, 80% of the professional fees up to Php 30,000.
Fasting Blood Sugar, Phosphate
• Laser Therapy for retinal detachment and glaucoma prescribed • 12 – Lead Elecrocardiogram C. OUT SIDE THE PHILIPPINES
by an affiliated physician up to P10,000/eye/member/year • Ultrasound of the Gallbladder and kidney
• Cauterization of Warts up to P1,000/year / member • Treadmill Stress Test OR Barium Enema
• Maxicare shall reimburse 80% of the total hospital bills and
• Speech Therapy up to 12 sessions /member /year (stroke patients 80% of the professional fees up to Php 30,000.
only) Gold Plan : Semi Executive Check Up
VI. DENTAL BENEFIT (optional at P650
• Physical Examination
II. IN PATIENT CARE /member /year)
• Urinalysis
• Room and Board Accommodation • Fecalysis
• Annual Oral/Dental Examination & Consultation
• Use of Operating and Recovery Rooms • Chest X-ray
• Emergency Dental Treatment
• Use of Intensive Care Unit (ICU) • CBC (Complete Blood Count)
• Annual Oral Prophylaxis
• Professional Fees of attending doctor(s) • Blood Chemistry (FBS, SGPT, Cholesterol, Creatinine, Uric Acid)
• Simple tooth extractions
• Drugs and medicines for use in the hospital • 12-Lead ECG
• Restorative and Prosthodontic Treatment Planning
• Whole blood and human blood products and IV fluids • Papsmear
• Permanent fillings - 2/year
• X-ray, laboratory examinations and diagnostic tests
• Unlimited temporary fillings, as needed
• Dressings, casts and sutures Silver Plan: (Routine)

APPLY NOW. For more information, contact Mark Gastardo (02) 9047340 / 0917 785 3993 / maxicareinquiry@gmail.com. Visit http://maxicareinquiry.blogspot.com
 • Desensitization of hypersensitive teeth – 2/year PRE EXISTING CONDITIONS Non Dreaded Conditions - Up to card limit for all plans
• Simple adjustment of dentures A) 1st year Dreaded Conditions - Up to card limit for all plans
• Recementation of loose crowns, Inlays or Onlays 1) Non Dreaded Conditions - Silver –P5,000 / Gold – P10,000 / Platinum
– P15,000 / Platinum Plus – P20,000
VII. OTHER BENEFITS & SPECIAL 2) Dreaded Conditions - Silver –P5,000 / Gold – P10,000 / Platinum –
CONDITIONS P15,000 / Platinum Plus – P20,000
B) 2nd year
Non Dreaded Conditions - Up to card limit
• Congenital Illnesses up to P20,000 /member/year Dreaded Conditions - Silver –P5,000 / Gold – P10,000 / Platinum –
• Scoliosis whether congenital, pre-existing or acquired up to P15,000 / Platinum Plus – P20,000
P20,000 /member/year ACQUIRED CONDITIONS
Age PLATINUM PLUS Php 200,000 Large PLATINUM Php 150,000 Regular
Group Private Private
Annual Semi-Annual Quarterly Annual Semi-Annual Quarterly
2-5 36,604 19,766 10,249 21,272 11,487 5,956
6 - 10 30,541 16,492 8,551 17,372 9,381 4,864
11 - 15 25,721 13,889 7,202 14,304 7,724 4,005 Age PLATINUM PLUS Php 200,000 Large Private PLATINUM Php 150,000 Regular Private
16 - 20 25,015 13,508 7,004 13,337 7,202 3,734 Group Annual Semi-Annual Quarterly Annual Semi-Annual Quarterly
21 - 25 24,891 13,441 6,969 13,841 7,474 3,875 2-5 30,505 16,473 8,541 19,480 10,519 5,454
26 - 30 25,721 13,889 7,202 15,130 8,170 4,236 6 - 10 25,534 13,788 7,150 15,974 8,626 4,473
31 - 35 30,199 16,307 8,456 17,627 9,519 4,936
11 - 15 22,648 12,230 6,341 13,270 7,166 3,716
36 - 40 37,159 20,066 10,405 22,695 12,255 6,355
16 - 20 20,939 11,307 5,863 12,283 6,633 3,439
41 - 45 46,349 25,028 12,978 30,260 16,340 8,473
21 - 25 21,114 11,402 5,912 13,014 7,028 3,644
46 - 50 54,609 29,489 15,291 40,258 21,739 11,272
26 - 30 21,963 11,860 6,150 14,170 7,652 3,968
51 - 55 61,210 33,053 17,139 48,701 26,299 13,636
31 - 35 24,429 13,192 6,840 16,714 9,026 4,680
INDIVIDUAL

56 - 60 67,262 36,321 18,833 54,930 29,662 15,380

61 - 65 * 75,242 40,631 21,068 61,978 33,468 17,354 36 - 40 27,437 14,816 7,682 20,692 11,174 5,794
Age GOLD Php 100,000 Regular Private Silver Php 60,000 Semi Private 41 - 45 34,593 18,680 9,686 26,392 14,252 7,390
Group Annual Semi-Annual Quarterly Annual Semi-Annual Quarterly 46 - 50 45,339 24,483 12,695 34,727 18,753 9,724

FAMILY
2-5 17,372 9,381 4,864 12,866 6,948 3,602 51 - 55 52,744 28,482 14,768 42,000 22,680 11,760
6 - 10 13,600 7,344 3,808 10,720 5,789 3,002 56 - 60 60,131 32,471 16,837 49,131 26,531 13,757
11 - 15 11,191 6,043 3,133 9,073 4,899 2,540 61 - 65 * 67,952 36,694 19,027 55,617 30,033 15,573
16 - 20 10,709 5,783 2,999 8,630 4,660 2,416 Age GOLD Php 100,000 Regular Private Silver Php 60,000 Semi Private
21 - 25 10,462 5,649 2,929 8,630 4,660 2,416 Group Annual Semi-Annual Quarterly Annual Semi-Annual Quarterly
26 - 30 12,272 6,627 3,436 9,818 5,302 2,749 2-5 14,341 7,744 4,015 11,278 6,090 3,158
31 - 35 14,800 7,992 4,144 10,575 5,711 2,961 6 - 10 11,561 6,243 3,237 9,188 4,962 2,573
36 - 40 19,423 10,488 5,438 12,877 6,954 3,606
11 - 15 9,534 5,148 2,670 7,886 4,258 2,208
41 - 45 24,870 13,430 6,964 19,305 10,425 5,405
16 - 20 8,518 4,600 2,385 7,494 4,047 2,098
46 - 50 29,812 16,098 8,347 23,110 12,479 6,471
21 - 25 8,398 4,535 2,351 7,469 4,033 2,091
51 - 55 34,648 18,710 9,701 25,684 13,869 7,192
26 - 30 9,884 5,337 2,768 8,285 4,474 2,320
56 - 60 40,398 21,815 11,311 28,534 15,408 7,990
61 - 65 * 43,962 23,739 12,309 29,756 16,068 8,332 31 - 35 11,539 6,231 3,231 8,975 4,847 2,513
*for existing members only, renewable up to 65 years old 36 - 40 14,621 7,895 4,094 10,689 5,772 2,993
41 - 45 18,219 9,838 5,101 15,396 8,314 4,311

APPLY NOW. For more information, contact Mark Gastardo (02) 9047340 / 0917 785 3993 / maxicareinquiry@gmail.com. Visit http://maxicareinquiry.blogspot.com
 46 - 50 23,203 12,530 6,497 19,183 10,359 5,371
51 - 55 27,073 14,619 7,580 21,410 11,561 5,995
56 - 60 31,340 16,924 8,775 23,776 12,839 6,657
61 - 65 * 34,492 18,626 9,658 24,947 13,471 6,985

APPLY NOW. For more information, contact Mark Gastardo (02) 9047340 / 0917 785 3993 / maxicareinquiry@gmail.com. Visit http://maxicareinquiry.blogspot.com