Maxicare Application Requirements for Individual and Family Applicants

Maxicare Application Requirements for Individual and Family Applicants

REQUIREMENTS FOR ENROLLMENT (Upfront Payment not required)

INDIVIDUAL APPLICATIONS

1. Application Form (Filled Out and Signed application form, complete with Height, Weight, Blood Pressure and TIN of the principal applicant)
2. Medical Requirements (principals or dependents 50-60 years old). Results within the last 6 months of

a) 12 Lead ECG / Electrocardiogram

b) Chest Xray

c) FBS / Fasting Blood Sugar

d) Total Cholesterol

e) HDL-C (High Density Lipoprotein)

f) LDL-C (Low Density Lipoprotein)

FAMILY APPLICATIONS

1. Application Form only (Filled Out and Signed application form, complete witHeight, Weight, Blood Pressure and TIN of the principal applicant)

2. Medical Requirements (principals or dependents 50-60 years old). Results within the last 6 months of

g) 12 Lead ECG / Electrocardiogram

h) Chest Xray

i) FBS / Fasting Blood Sugar

j) Total Cholesterol

k) HDL-C (High Density Lipoprotein)

l) LDL-C (Low Density Lipoprotein)

3. Supporting Documents

a) MARRIED APPLICANTS

a) If enrolling the spouse only – photocopy of Marriage Contract, NSO or Civil Registrar’s copy

b) If enrolling the spouse and the kids – photocopy of birth certificate per child, NSO or Civil Registrar’s copy

b) SINGLE APPLICANTS

a) If enrolling the parent/s only – photocopy of principal/applicant’s birth certificate, NSO or Civil Registrar’s copy

b) If enrolling the parents and the siblings – photocopy of per sibling’s birth certificate, NSO or Civil Registrars copy.

ALIEN RESIDENTS AND NATIONALS

1. Same requirements stated above

2. Must also submit

a. Photocopy of ACR ID (Alien Certificate of Residency)

b. Certificate of Employment (if applicable)

If you need more clarifications on Maxicare’s Application procedure, you may call Tel (02) 6228892 Mobile 0917 804 6275 Email: maxicareinquiry@gmail.com