MAXICARE PRE EXISTING NON DREADED AND DREADED CONDITIONS

PRE EXISTING NON DREADED AND DREADED CONDITIONS*

* Applies to Family and Individual Accounts

* These conditions are waived under Maxicare's Corporate Plans

NON DREADED CONDITIONS are as follows, but not limited to:

1. All tumors (benign masses)

2. Anal Fistulae

3. Arthritis

4. Bronchial Asthma

5. Buergher’s Disease

6. Cataract and Glaucoma

7. Cholecystitis, Cholelithiasis, Cholecystolithiasis

and Choledocholithiasis

8. Ear-Nose-Throat conditions requiring surgery

(except cancers which are considered dreaded

conditions)

9. Endometrioses/Dysfunctional Uterine Bleeding

(except if caused by uterine malignancies)

10. Gastric or Duodenal Ulcers

11. Hallux valgus

12. Hemorrhoids

13. Hernias (Congenital Hernia will have coverage

as listed in the Congenital Clause)

14. Migraine

15. Muscular Dystrophies (Duchenne, Becker,

limb girdle, facioscapsulohumeral, myotonic,

oculopharyngeal, distal, and Emery-Dreifuss)

16. Ovarian cysts (except Ovarian Malignancies)

17. Peripheral Nervous System Diseases (except

Multiple Sclerosis and GBS)

18. Tuberculosis (Pulmonary or Extrapulmonary

including Pott’s disease)

19. Uncomplicated Hypertension

20. Urinary Tract Stones/Calculi

21. All complications resulting from above list of

conditions

DREADED CONDITIONS are as follows, but not limited to:

1. All cancers (malignant masses) including

carcinoma in situ and related conditions

2. Blood Dyscrasias (Leukemia, Idiopathic

Thrombocytopenic Purpura, etc)

3. Central Nervous System Infections

(Poliomyelitis/Meningitis/Encephalitis)

4. Cerebrovascular Accident (Stroke, Cerebral,

Cerebellar and all Intracranial Hemorrhage)

and related conditions

5. Chronic Cardiovascular Diseases

(Complicated Hypertension and related

conditions, Aortic Dissection, Abdominal Aortic

Aneurysm, etc.)

6. Chronic Endocrine Disorders and their

complications (Dyslipidemia, Impaired Fasting

Glucose, Impaired Glucose Tolerance,

Obesity, Diabetes Mellitus, Hormonal

Dysfunctions, etc.) excluding surgical

treatment/procedures for obesity-exclusion

7. Chronic Gastrointestinal Diseases (ex. Irritable

Bowel Syndrome, Crohn’s disease)

8. Chronic Genito-urinary Disorders

9. Chronic Kidney Disease/Failure

10. Chronic Liver Parenchymal Diseases (Liver

Cirrhosis, Chronic hepatitis, etc)

11. Chronic Pulmonary Diseases except asthma

(COPD, emphysema, and other chronic lung

disease)

12. Collagen-Vascular/Connective Tissue/

Immunologic Disorders

13. Complications of immuno-compromised state

(except HIV/AIDS)

14. Injuries incurred prior to and up to one year

from date of effectivity and their subsequent

complications

15. Systemic Lupus Erythematosus including

Lupus Nephritis

16. Thyroid conditions (Hypothyroidism,

Hyperthyroidism) except Thyroid masses

17. Valvular Heart Diseases (except for surgeries

for valve correction, ie valvuloplasty)

18. Any illness other than above which would

require Intensive Care Unit Confinement

19. All complications resulting from above list of

conditions

For more information about Maxicare’s Pre Existing Conditions coverage, you may inquire at (02) 6228892; 09178046275 or email us at maxicareinquiry@gmail.com

Thank you.

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Worried about expensive hospital bills?
Enroll with MAXICARE
Individual, Family & Corporate
Direct Line: (02) 6228892 Mobile: 09178046275

Email: maxicareinquiry@gmail.com
http://maxicareinquiry.blogspot.com

Maxicare Corporate Enrollment Process

Maxicare Corporate Enrollment Process

Step 1: Fill out the MAXICARE CORPORATE ENROLLMENT TEMPLATE that was emailed to you and email those to maxicareinquiry@gmail.com For instructions on how to fill out the MAXICARE CORPORATE ENROLLMENT TEMPLATE, go to http://tinyurl.com/maxicaretemplate

Step 2: (after 2 days) Pre Service Agreement Conforme. This will be emailed and sent to you via courier. Kindly sign conforme and send that back to Maxicare. A separate set of instructions will be given to you for this document.

Step 3: (1 week after submission of conforme): ID Kits Delivery. This will be delivered at your declared billing address. The cards will be ready to use depending on your official start date as indicated in your conforme.

Step 4: (2 weeks after delivery of ID Kits) Billing Issuance. This will be delivered at your declared billing address. This is due 30 days from the statement date. For our payment centers, visit http://tinyurl.com/maxicarepaymentcenters

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

MAXICARE CORPORATE ENROLLMENT TEMPLATE.

The Template has 3 sheets:

Info Sheet – basic info about the company

Principals – masterlist of principals/employees that are enrolling

Dependents – masterlist of dependents that are enrolling

Principals Sheet

Philhealth – indicate “Required” (all employees were assumed Philhealth members and are required to file their Philhealth incases of confinement)

Rider – leave blank. I will fill this up myself

The plan of choice (Silver, Gold, Platinum)

• could be uniform for all principals and dependents (eg. Everyone under Gold Plan)
• according to the position of the company, let’s say Platinum for President/Owner, Gold for Managers, Silver for Staff
• The dependents plan could either be uniform for all dependents of the company or consistent with the position of the principals. Let’s say, All dependents of the President/Owner are under Platinum, All dependents of Managers are under Gold and all dependents of the Staff are under Silver
• The plans per employee should also be consistent. Let’s say a Male Manager has 3 dependents. It cannot be if his wife is under Gold Plan and the kids are under Silver. They should be the same.
• Note: Company can choose from any of the plan types from any of the 6 options BUT all plan types must come from one (1) option only.

Example:

Executives - Platinum

Managers - Gold

Rank and File – Silver

But they should come from one (1) option only

Dependents Sheet:

The total number of dependents must be equal to at least 75% of the population of the principals/employees

For example: 5 employees x .75 = 4 dependents even if all 4 dependents came from 1 person only

Hierarchy of Enrollment and Age Limit

For married principals

1^st - spouse (must be 65 & below)

2^nd - eldest child (must be 21 & below)

3^rd - up to the youngest child (must be 21 & below)

For single principals

1^st - mother (must be 65 & below)

2^nd - father (must be 65 & below)

3^rd - eldest sibling (must be 21 & below)

4^th - youngest sibling (must be 21 & below)

Thus, if a married principal would like to enroll 1 dependent, he MUST enroll his wife first. If he wants to enroll 2 dependents, he MUST enroll his spouse and his eldest child. The same principle is applied for the single applicants based on the hierarchy stated above.

Exemptions from the Hierarchy

A dependent can be exempted or excluded from the hierarchy. The principal applicant can then now skip and proceed to the next eligible dependent.

Examples:

1. Wife is currently enrolled with another HMO
2. Mother is already deceased
3. Husband is working abroad
4. Father is over aged
   
   
   

Should by any chance, you are only able to submit 4 principal names, your company’s application as a group account will not be processed unless the minimum number of 5 applications is submitted and approved by Maxicare’s underwriting

Thank you.

--

Worried about expensive hospital bills?
Enroll with MAXICARE
Individual, Family & Corporate
Tel (02) 6228892 Mobile 0917 804 6275
http://maxicareinquiry.blogspot.com

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

MAXICARE Healthcard Benefit for Startups & Small Companies for as low as P2900 per employee per quarter

MAXICARE Healthcard Benefit for Startups & Small Companies for as low as P2900 per employee per quarter

For as low as P2,900 per quarter and with a minimum of 5 employees, you can sign up now for a Maxicare Healthcare Corporate Program.
Very ideal for small companies like consultancy firms, agencies, start up businesses, Small and Medium Enterprises and etc.

Enjoy the following corporate benefits:
• Comprehensive Healthcare Coverage with Outpatient and Consultations, Inpatient and Confinement, Emergency Care, Preventive Care, Annual Check Up, Dental Benefits and Life Insurance
• Easy Application Process, No Application Forms, No Processing Fees
• Waived Pre Existing Conditions
• With Annual, Semi Annual and Quarterly Payment Terms
• Direct to Access to Top Hospitals like Makati Medical Center, Asian Hospital, St. Lukes, The New Medical City and 700 other hospitals and clinics nationwide

Quarterly Premium Rates as low P2,900+ depending upon your room accommodation and maximum benefit limit

Sign up and have your employees’ account activated in 1 week! No upfront payment required.

Apply now!

Tel (02) 6228892 Mobile 0917 804 6275
Email: maxicareinquiry@gmail.com
http://maxicareinquiry.blogspot.com

What Health Insurance Do You Have?

What Health Insurance Do You Have?
Posted by blankPixels on Saturday, August 14, 2010
Labels: All about me, Family/Friends, Random Rants

When I was still working, I never really worried about health insurance since the companies I was working for took care of that. I've been covered by different health insurance companies, including Intellicare and Maxicare. And, to be honest, I never took advantage of the benefits I got from them. I should be thankful, right? I mean, that's because I'm healthy, right

Well, honestly, I should've taken advantage of my health insurance coverage and had myself undergo quarterly checkups. Or at least for a dental checkup. I never took my health insurance seriously because my mother is a nurse and she knows a lot of doctors. Thank God I never got sick to the point that I needed to be confined in a hospital.
Even after my mother's health insurance coverage helped us a lot financially when my brother Ken had dengue, my mother underwent surgery to remove her goiter and I had my checkup(I found out I have PCOS and myoma), I still was a bit dependent on my mother's health insurance coverage as a government employee.

I'm guessing that I didn't take the health insurance coverage I was getting from the companies I worked for because I knew, at the back of my head, that I won't be staying with them for long anyway. I guess I'm not really programmed to work for a boss.
So, now, I only have these PhilHealth cards with me. The one on top, I got from my mother. That's one thing we are thankful for that my mother's a government employee – the benefits. The other one is my own PhilHealth card.

Source:
http://www.justanotherpixel.net/2010/08/what-health-insurance-do-you-have.html

MAXICARE PAYMENT CENTERS

We accept payments via credit card, bills payment at BDO/ Equicom and selected CIS Bayad Centers. As we have added several payment options (and limited collectors), we try to limit pick up of checks to corporate accounts . In addition, we do not pickup cash payments.

PAYMENT DUE DATE:
Please refer to your statement of account or service agreement with Maxicare for your payment due date. If the due falls on a weekend or holiday, please settle on the working day before said date to ensure continuing healthcare coverage. Please allow three (3) working days for posting of payments made through Equicom Savings Bank, BDO and Bayad Center.

You will also receive a hardcopy of the billing statement through your declared billing address.

This is normally due 15 days from the statement date unless stated in the Billing Statement. Failure to pay means cancellation of membership for New Members. A penalty fee of P500 will be charged for existing members (per enrolled member for Family Accounts).

Payment Options:

A) Any BDO or Equicom Savings Bank Branch nationwide using Bills Payment Form

Company Name: Maxicare Healthcare Corporation

Subscriber Account Number: This is the reference number located at the upper right portion of your billing statement eg. ref 2-00000-1-00006821. Please take note that your reference number varies per billing statement so on your next billing statement, kindly copy the reference number from the current billing statement always.

Subscriber Name: Name of Principal Member (for Individual and Family) / Company Name (for Corporate Account)

B) Bayad Centers - Selected Branches

To see list click http://www.maxicare.com.ph/wp-content/uploads/2010/08/Bayad-Centers.pdf

Click Payment Options

Click Bayad Centers

C) Cash/Check/Credit Card at the Maxicare Head Office (VISA, MasterCard, JCB and/or American Express Credit Cards are accepted.)

19th Floor, Medical Plaza Makati Building

Amorsolo corner dela Rosa Streets

Legaspi Village, Makati City

D) Credit Card Auto Debit Option (VISA, MasterCard, JCB and/or American Express Credit Cards are accepted.)

(Individual and Family), this can be done after settlement of first billing statement

(Corporate), immediately after enrollment

From payment, kindly expect delivery of your ID within 1 week and you can already use your MAXICARE card.

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