Maxicare modernizing, taps new technologies

Local firm Maxicare Healthcare Corp. is seeking to modernize the country’s healthcare industry by tapping new technologies that will make it easier for claimants to get affordable medical attention when they need it.

In a recent briefing, the company said it had introduced new features that made healthcare services more accessible to its 600,000 clients, and HMO [health maintenance organization] services cheaper for employers and other users.

By 2013, the company said it planned to raise its client base to one million, taking advantage of the country’s growing economy and the boom in certain industries, particularly the business process outsourcing sector.

“The healthcare situation now in the Philippines shows that there are a lot of opportunities for companies like us,” Maxicare president Jose Pastor Puno told reporters.

Of the country’s 93 million people, about 65 million are covered by the state-run PhilHealth program. “But the coverage of PhilHealth is very limited. Many of our own members are also PhilHealth members,” Puno said.

He said private HMO companies today covered only about three million Filipinos. “Most of these are working class people employed by big corporations,” he said. This means there is still a large, untapped market of employees that don’t have health coverage, he added.

Puno said the company also wanted to tap small and medium enterprises in the country that were just starting to provide healthcare benefits to their employees.

To make its services more attractive to new clients, Maxicare said it continued to expand its network by signing new partnership with doctors and other healthcare professionals in the country.—Paolo G. Montecillo

The actual article can be viewed here

http://business.inquirer.net/34365/maxicare-modernizing-taps-new-technologies

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SMEs, overseas workers to boost HMO sales

MAXICARE HEALTHCARE Corp., a health care management organization (HMO), is looking to boost membership to at least a million registrants within two years as it upgrades facilities and expands networks, ranking officials yesterday said.

“By 2013, we are looking at a one-million membership target,” said Jose Pastor Z. Puno, Maxicare president and chief executive said in a press launch of the company’s new corporate headquarters in Makati City.

The new facility consolidates the firm’s operations under one roof,
At present, the company serves more than 600,000 members nationwide.

The company’s future growth will be driven by the health coverage purchased by small-to-medium enterprises (SMEs) for their employees, a market which currently account for around 20% of the Maxicare’s plans, Mr. Puno said.

Further, the company is looking to attract overseas Filipino workers (OFWs) to avail themselves of the health plans.

“There are still a lot of areas that we have to tap. OFWs are a lucrative source, and we have been looking at that market for a long time,” Mr. Puno said.

“OFWs have priorities, they provide for the basic requirement for their families, and one of them is healthcare. Hopefully, in time, we will be able to develop that market,” he added.

In addition to its flagship HMO service for corporate clients and SMEs , Maxicare offers an array of plans for families and individuals, and an plan to be used solely for emergency purposes.

The company said future growth will also be boosted by its vast network of providers, its seven customer care and 11 primary care centers, and a comprehensive health program.

“We have achieved great success over the years and in our upcoming 25th anniversary next year, we want to ensure that we will continue to provide the best healthcare program to our current and prospective members. That is why we have been enhancing our service offerings and upgrading our facilities,” Mr. Puno added.

But despite its reported leadership in the HMO industry, the company is not eyeing a public listing yet.

“It’s not really a big issue for us. We know that the company is ripe for an IPO (initial public offering), but at this point, it is not a priority,” Mr. Puno said.

Maxicare, established in 1987, claims to have served over 800 corporations along with SMEs, individuals and families, who together account for 600,000 card holders at present.

Further, it has a network of over 25,000 doctors, 3,700 dental providers and 950 hospitals and clinics nationwide, 65% of which are tertiary institutions.

The company incurred P76 million in net income last year, with P3.63 billion in earned membership fee revenues, according to a press statement.

Maxicare is a member firm of the Equicom Group. -- FJGDLF

The actual article can be viewed here

http://www.bworldonline.com/content.php?section=Corporate&title=SMEs,-overseas-workers-to-boost-HMO-sales&id=41680

|Ask me about MAXICARE Corporate Healthcard for only 5 employees!|

Ideal for Sole Proprietors, Family Businesses and Small Companies

| 02-6228892 | 09178046275 | Email: maxicareinquiry@gmail.com |

http://maxicareinquiry.blogspot.com/

Healthcard for Small & Start up companies from MAXICARE for as low as P3900 per employee per quarter

For as low as P3,300 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 P3,300+ 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!

Direct Inquiry: (02) 622 8892
Mobile: 0917 804 6275
Email: maxicareinquiry@gmail.com

INELIGIBLE GROUPS

INELIGIBLE GROUPS

Updated list of Maxicare Plus Ineligible Groups for your guidance and reference:

The following industries, businesses or types of cases are ineligible for coverage under Maxicare Plus:

_ Groups where no employer-employee relationship exists

_ Groups which involve special hazards

_ Political groups

_ Nuclear/ chemical / natural gas plants

_ Firemen

_ Manufacturers of ammunition or explosives

_ Full time athletes

_ Drillers (oil/ water/gas)

_ Sauna, Turkish baths, massage parlors or similar enterprises

_ Private households

_ Underground mine workers & workers using explosives (mining risks not covered)

_ Logging/Forestry

_ Law Firm

_ Government Institution

_ Oil Production

_ Pharmaceutical Groups (Manufacturing/Distributing)

_ Medical Groups

_ Media

_ Construction companies (Non-office based employees)

_ Education (except Pre-schools only)

_ NGOs and Cooperatives (except employees of the organization)

NOTE: Answered questionnaire for NGO accounts and Cooperatives is still needed for further

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

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Secure yourself with MAXICARE

For Individual, Family & Corporate

Tel: (02) 6228892 Mobile: 09178046275

Email: maxicareinquiry@gmail.com

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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