When you have finally decided to enroll under the Maxicare Individual and Family Program, the simplest, basic and maybe the only initial requirement is the Maxicare application form. Embedded in this page is the MAXICARE Application Form for the Individual, Family accounts. You can download the Maxicare application form by clicking on the download button located at the upper left corner of the presentation. To request for an electronic application form, call Tel (02) 6228892 Mobile 0917 804 6275 Email: maxicareinquiry@gmail.com or leave a comment here.
Once you receive the Maxicare electronic application form, you can fill up the Maxicare application from your computer once you open the file. After filling it up, kindly print the Maxicare application form and sign it. Maxicare Application forms without a signature will not be processed.
How to Submit the Form:
1) You may scan the document and email it back to maxicareinquiry@gmail.com
2) You may also fax it to us at 751-5164 loc. 1017
Kindly attention the faxed document to:
Attn: Mark Gastardo
Please call Tel Tel (02) 6228892 Mobile 0917 804 6275 Email:
maxicareinquiry@gmail.com to confirm that you have faxed the Maxicare
application form.
3) Send the documents via courier to:
Mark Gastardo
Maxicare Healthcare Corporation
c/o Rachelle Reyes – Intermediaries Team
19F Medical Plaza Building Amorsolo cor Dela Rosa Sts.
Makati City
I shall inform you of your Maxicare application results within the week through telephone/email/SMS
Very important reminder: TIN or Tax Identification Number is always required except for children and students
If you need more clarifications on Maxicare’s Application Form, you may call Tel (02) 9047340 Mobile 0917 7853993 Email: maxicareinquiry@gmail.com or leave a comment here
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Is your purse ready when you get sick?
Secure yourself with MAXICARE
For Individual, Family & Corporate
Tel (02) 6228892 Mobile 0917 804 6275
Email: maxicareinquiry@gmail.com
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