Professional Documents
Culture Documents
PHILIPPINES, INC.
Period of Coverage
February 1, 2020 to January 31, 2021
COMPANY PROFILE
WHO WE ARE
Established in 1995
1M members &
More than 20 years of
counting
solid experience
ELIGIBILITY
PLAN LIMITS
AVAILMENT
OTHER BENEFITS
ELIGIBILITY
PRINCIPALS
Employees up to 65 years old.
DEPENDENTS
Eligible dependents of Employees,
provided Hierarchy is followed.
SINGLE
PRINCIPALS
1. Parents
Not over 65 years old
SINGLE PARENTS
PRINCIPALS
2. Parents
Not over 65 years old
MARRIED
PRINCIPALS
1. Legal Spouse
Not over 65 years old
EXTENDED DEPENDENT
3. Parents
Not over 65 years old
UNMARRIED
PRINCIPALS
Employee PayPal - 100% Premium PayPal - 100% Premium PayPal - 100% Premium PayPal - 100% Premium
Children (Up to 3) PayPal - 100% Premium NA PayPal - 100% Premium PayPal - 100% Premium
Notes:
1. Deductions will start from March onwards. March deduction will be for 2 months (Feb and March) and April onwards it will be
monthly deduction
2. Please contact PayPal Support (Employee Central) for any inquiries on the salary deduction
3. All premiums are in PHP & Vat Inclusive
ENROLLMENT
POINTERS
Skipping of Hierarchy:
Dependents with Existing Active HMO membership
Dependents residing/working abroad
Legally Separated
Death
PLAN LIMITS
ROOM AND BOARD MAXIMUM BENEFIT LIMIT
(Regardless of the price) (Per type of Illness)
NOTE:
WITH ACCESS TO HEALTHWAY MEDICAL CLINICS, MAKATI MEDICAL CENTER, ST. LUKE'S (QC & GLOBAL CITY), ASIAN
HOSPITAL, CARDINAL SANTOS, THE MEDICAL CITY AND ITS AFFILIATED CLINICS
PLAN LIMITS
PRE-EXISTING CONDITION (PEC)
Existing New
Principals
Dependents Dependents
Up to MBL Up to MBL Up to MBL
• Nature can be clinically determined to have started whether the member is aware or not
• E.G. Hypertension, goiter, asthma, TB, gall or kidney stones, diabetes, tumors, myoma, arthritis,
hernia, prostate disorders…etc.
PREVENTIVE
FOR ALL MEMBERS
NOTE:
With access to Healthway Medical Clinics
OUT-PATIENT
Speech (for stroke patients) up to 12 sessions/year.
Note: Therapy of one (1) body area shall be considered as one (1) session
NOTE:
With access to Healthway Medical Clinics
OUT-PATIENT
AVAILMENT PROCESS
Present your Intellicare Membership Card with two (2) valid IDs at the facility’s
reception area or HMO / Industrial office for membership status validation.
Accomplish the Referral Control Sheet (RCS 1 / RCS 2) then proceed with availment.
NORTH EDSA
2/F Philippine College of Surgeon Bldg., 992 North Edsa,
Quezon City
METRO MANILA ☎: (02) 8352-4676 / (02) 8352-4677
MAKATI – AYALA NORTH EXCHANGE
3/F Retail 61 & 62, Amorsolo St., Ayala Ave., ALABANG
Makati City 2/F Sycamore ARCS 1 Building, Buencamino St. cor.
☎: (02) 8587-8053 Alabang-Zapote Road, Alabang, Muntinlupa City
☎: (02) 8556-3596 / (02) 8556-3592
MAKATI – FILOMENA BLDG.
6/F Filomena Bldg., 104 Amorsolo St., Legaspi Village,
Makati City REGIONAL
☎: (02) 8519-6787 / (02) 8817-1464 / (02)8 869-3289 CALAMBA
Unit 201-203 SQA Corporate Center, Barangay 1, National
BGC Highway Crossing, Calamba City, Laguna
G/F Citibank Plaza, 34th St. Corner Lane D., Bonifacio ☎: (045) 499-8417 / (045) 499-8419
Global City, Taguig City
☎: (02) 8352-8335 / (02) 8362-0042 STA. ROSA
2/F Carvajal Building 2, National Highway, Balibago City,
MANILA Sta. Rosa, Laguna
5/F Times Plaza Bldg., U.N. Ave. corner Taft Ave., Ermita, ☎: (049) 508-1806 / (049) 306-0397
Manila City
☎: (02) 8353-6807 / (02) 8353-6808 CLARK
G/F BPO Building 5, SM City Clark, M.A. Roxas
PASAY Highway,Brgy. Malabanias, Angeles City, Pampanga
Scape Bldg., Macapagal Avenue, cor. Pearl Drive, Central ☎: (045) 499-8417 / (045) 499-8419
Business Park 1, San Rafael, Brgy. 76, Pasay City
☎: (02) 8541-5645 / (02) 8838-0627 CEBU IT PARK
Unit 203 TGU Tower, Asiatown, IT Park Apas, Cebu
ORTIGAS ☎: (032) 479-9261
G/F AIC Grande Tower, Sapphire St. cor. Garnet Road,
Ortigas Center, Pasig City CEBU CYBERGATE
☎: (02) 8584-2430 / (02) 8584-1013 L/3 Robinsons Cybergate, 2029 Don Gil Garcia & J.
Llorente St., Capitol Site, Cebu
☎: (032) 236-9028 / (032) 238-3922 / (032) 238-7672
PREFERRED NETWORKS
1 2 3 4
Save on travel cost Save on time 24/7 | 365 days a year Save money
Anytime. No Line.
Present the admitting order, your Intellicare Membership Card & two (2) valid IDs
at the admitting section of the hospital for membership status validation and
scheduling of confinement. IN-PATIENT
FORM (RCS 3)
Sign the Referral Control Sheet (RCS 3) issued by the visiting Intellicare
Patient Relations Officer.
If the entitled room is not available, member may occupy (1) One
category higher up to 24 hours (except suite room) without
incremental charges.
MAXIMUM
Up to MBL Up to Php30,000 Up to Php30,000
COVERAGE thru reimbursement thru reimbursement
HOSPITAL
BILLS 100% 80% 100%
PROFESSIONAL
BILLS 100% *RVS 80% *RVS 100% *RVS
REQUIRED DOCUMENTS
Original Official Receipt (with TIN)
Statement of Account from the Hospital
Medical Certificate
Laboratory results (if with diagnostic procedure)
Operative record with histopath (if with operation)
Police report & Medico-legal Report (if required)
NOTE:
Submit to Intellicare not more than 30 days from expiration of treatment.
Processing of the request is within 20 working days upon receipt of complete documents.
☎: 1-800-101DENTAL (PLDT Toll-free) | (02) 8911-7777 (PLDT Trunk Line)
DENTAL
Thru:
DENTAL
Thru:
DENTAL
Thru:
AVAILMENT PROCESS
MOBILE NUMBERS:
(0923) 809-5376 (Sun)
(0916) 761-5277 (Globe)
Proceed to the dental clinic on your scheduled date and present your Intellicare DENTAL FORM
Membership Card with two (2) valid IDs for membership status validation.
d
Electrocauterization of skin lesions such as plantar warts, flat warts, periungual warts, filiform
warts and molluscum contagiosum, (from face down except genital warts and condyloma acuminata)
shall be covered up to Php2,000.00 per member per year to be done at Aventus Clinics provided that
an accredited physician recommends it and only for cases that affect the physiological functions of
the member (not for cosmetic/aesthetic purposes).
ADDITIONAL BENEFITS
Sclerotherapy for varicose veins (excluding medicines and for cosmetic purposes) shall be covered
up to Php30,000 per member per year provided that it is medically necessary and recommended by
an affiliated vascular surgeon (not for aesthetic purposes).
Allergy Testing/ Allergy screening shall be covered up to Php2,500.00 per member per year per
member per year if prescribed by Accredited Physician.
Tuberculin Test shall be covered up to Php600.00 per member per year if the member shows
symptoms of Tuberculosis and if prescribed by accredited physician.
ADDITIONAL BENEFITS
Treatment for animal bites and tetanus shall be covered as follows:
-Passive and active vaccines for treatment of animal bites and tetanus - up to Php20,000.00 per
member per year.
- Inital treatment for animal bites - up to the maximum benefit limit per member per year for the first
twenty-four (24) hours from the time the member was bitten.
Botox injection shall be covered up to Php5,000.00 per member per year if recommended by an
accredited/ affiliated physician to be medically necessary (NOT for aesthetic/beautification
purposes).
ADDITIONAL BENEFITS
Work-related conditions shall be covered up to the maximum benefit limit per member per year
subject to the exclusions and limitations of the contract.
Motor vehicular accidents shall be covered up to the maximum benefit limit per year subject to the
exclusions and limitations of the contract and a Police report MUST be submitted to Intellicare for
evaluation.
Provoked and unprovoked assault including domestic violence whether initiated by a known or
unknown third party shall be covered up to the maximum benefit limit per member per year subject
to the exclusions and limitations of the contract and a police report must be submitted to Intellicare
for evaluation.
ADDITIONAL BENEFITS
Scoliosis including necessary procedures, except physical therapy sessions, whether congenital, pre-
existing, developmental or acquired shall be covered up to Php40,000.00 per member per year
Note: Physical therapy sessions shall form part of the limit for Physical therapy/ Occupational therapy
limit
Congenital conditions including Congnital Hernia shall be covered up to Php40,000.00 per member
per year subject to pre-existing condition limit (whichever is lesser).
Note: Physical therapy sessions shall form part of the limit for Physical therapy/ Occupational therapy
limit.
ADDITIONAL BENEFITS
Coverage for complications of congenital conditions shall form part of the limit for congenital illness
Consultation for chronic dermatoses shall be covered up to the maximum benefit limit per member
per year.
HIV/ AIDS shall be covered up to the maximum benefit limit per member per year. HIV Screening
and out-patient medicines are not covered.
Hepatitis B (if acquired) shall be covered up to the maximum benefit limit per member per year.
ADDITIONAL BENEFITS
Optical benefit which includes optical consultations, examinations, contact lens, spectacle shall be
covered thru reimbursement up to Php3,500.00 for per member per year.
Note: Maternity benefit may be covered outright if availed in an accredited hospital through an
accredited physician. Otherwise, coverage shall be on a reimbursement basis.
ADDITIONAL BENEFITS
Please note that INTELLICARE will only process maternity reimbursement if all originals of the
following pertinent documents are submitted to INTELLICARE:
- Official Receipt
- Certified True Copy of Birth Certificate
- Medical Certificate (stating nature of delivery: i.e. Normal, Caesarian)
- Statement of Account (with itemized hospital bills)
Note: Maternity benefit may be covered outright if availed in an accredited hospital through an
accredited physician. Otherwise, coverage shall be on a reimbursement basis.
Gender Reassignment Surgery (GRS) coverage
GRS Guidelines:
• PayPal employees (only) are eligible for GRS benefit (one-time) upon completion of probation with PayPal
Philippines
• GRS benefit shall be covered for employees who are diagnosed with Gender Dysphoria
• Maximum limit for the gender reassignment surgery related expenses is PHP 200,000 per employee. This is over
and above the MBL.
• Refer GRS sub-limits that are part of PHP 200,000 GRS Benefit:
• Consultations through accredited/non-accredited endocrinologist including prescribed hormonal treatments
(through IV or injection only) shall be covered up to PHP 20,000 per employee per year through
reimbursement
• Consultation reimbursement through Psychiatrist shall have a maximum limit of PHP 1,500 per consultation
www.fwd.com.ph ✉: corporateclaims.ph@fwd.com
LIFE INSURANCE
FOR PRINCIPAL MEMBERS ONLY
Thru:
LIFE INSURANCE
FOR PRINCIPAL MEMBERS ONLY
Thru:
Illnesses / Conditions
Congenital abnormalities
Neuro-developmental & genetic disorders (which may result to mental retardation)
Developmental delay
Sexually transmitted diseases
Psychiatric and psychological illnesses
MEMBERSHIP CARD
NOTE:
LOST / DAMAGED CARDS: must be reported to Intellicare immediately.
REPLACEMENT FEE: Php100.00
CERTIFICATE OF COVER
NOTE:
In the absence of the membership
card, member may present the
Certificate of Cover (COC) signed by
an HR representative.
WEBSITE
www.intellicare.com.ph
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