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ER Health Assist 80 for Adults
  • ER Health Assist 80 for Adults
  • ER Health Assist 80 for Adults

ER Health Assist 80 for Adults

INFO

ER Health Assist 80 is a health voucher that covers multiple-use benefits for unlimited medical and dental consultations to Philcare Makati and MOA Clinics only and a single-use benefit up to Php 80,000 for outpatient emergency care and hospitalization coverage for viral, bacterial illnesses, and treatment of injuries resulting from accidents (except for stroke) in 500+ Philcare accredited hospitals nationwide.

PHP2,370.00
Vat Inclusive
Qty

When You Need It Most

ER Health Assist 80 is a health voucher that covers multiple-use benefits for unlimited medical and dental consultations to Philcare Makati and MOA Clinics only and a single-use benefit up to Php 80,000 for outpatient emergency care and hospitalization coverage for viral, bacterial illnesses, and treatment of injuries resulting from accidents (except for stroke) in 500+ Philcare accredited hospitals nationwide.


It covers the following up to the benefit limit:

- Room and board (Regular Private)

- Doctor's fees

- Laboratory and diagnostics procedures

-Special modalities of treatment as medically necessary during ER and subject to P5,000 inner limit

-Medicines (except vaccines) as medically necessary during  ER and confinement, subject to standard inner limits

-Diagnostics and therapeutic procedures as medically necessary during ER and confinement

 

Emergency cases are the sudden, unexpected onset of illness or injury, which at the time of contract reasonably appeared as having the potential of causing immediate disability or death or requiring the immediate alleviation of severe pain and discomfort. Emergency cases include but are not limited to the following: (a) Massive Bleeding; (b) Acute Appendicitis; (c) Fractures/multiple injuries secondary to accidents; (d) Convulsions; (f) illnesses or conditions resulting in moderate or severe dehydration such as diarrhea or fever; and (h) Syncope. Pre-existing conditions and those conditions under the general exclusions of PhilCare are not covered.***

 

Out-patient Benefit Coverage

One (1) year unlimited medical consultations (including pre-existing illnesses) through the following specialists at PhilCare Makati and Moa Clinics only.

o   Family Medicine

o   Internal Medicine

o   OB Gyne

o   Opthalmology

o   Dermatology

o   ENT


One (1) year standard dental coverage at Health Partners dental provider inclusive of the following:

Standard Dental Package:

-       Annual Dental examination and consultation

-       Emergency Out-patient Dental Treatment  to be availed at Health Partners dental provider

-       Oral prophylaxis - (Light cases only ,Covered Once a year)

-       Simple tooth extractions

-       Restorative and prosthodontic treatment planning

-       Temporary Fillings – (unlimited as needed)

-       Desensitization of hypersensitive teeth

-       Simple adjustment of dentures

-       Re-cementation of loose crowns, inlays and onlays

-       Dental Nutrition and Dietary Counseling

-       Pallative treatment for simple mouth sores and blisters

-       Pre-natal check of teeth and gums

-       Temporo Mandibular Joint Consultation

-       Gum treatment for cases like inflammation or bleeding

 

Other Benefit Coverage

With P50,000 accidental death and dismemberment coverage

 

Age Eligibility and Validity

ER Health Assist 80 for Adult is for age 18 to 64 years old and is valid for 1 year upon activation date. Benefit starts 7 days after activation date. The voucher is non-transferable once activated.


PhilHealth coverage is required during admission. However, for those who do not have PhilHealth coverage, one may just pay the PhilHealth portion of the hospital bill before discharge.


Coverable Emergency cases

Acute cases of bacterial and viral infections such as appendicitis, bronchitis, gastritis, gastroenteritis, pharyngitis, urinary tract infections sinusitis, tonsillitis, upper respiratory tract Infection, amoebiasis, cellulites, dengue fever, pneumonia and typhoid fever. Accidents except for cerebrovascular accidents (stroke) and injuries suffered because of member’s misconduct, voluntary participation in hazardous sport or activity and military service or under conditions of war.

 

Non-Coverable Emergency cases

Pre-existing, congenital and maternity related conditions are not covered.  Also those cases and conditions declared under the standard general exclusions are not covered.  Pre-existing and congenital conditions – An illness or condition shall be considered pre-existing if, prior to the effective date of health coverage the pathogenesis of such illness or condition has started, whether or not the member is aware of such illness or condition. 


Top-Notch Assistance Offline and Online

PhilCare’s services are delivered through a combination of people and digital channels. People channels include a team of Liaison Officers in key hospitals assisting members for admission or confinement, Quick Assist desks in major hospitals, a 24/7 Contact Center manned by nurses and supported by a state of the art technology platform, and finally, PhilCare-owned clinics and the PhilCare Clinic@Work worksite clinics supported by a competent medical team.

 

Our intense focus on the customer inspired us to pioneer innovation and transform customer experience through digital channels. Find a provider through PhilCare’s mobile app, HeyPhil! Check your health program, transactions, and the latest news about health and wellness through our interactive portals. Easily repurchase your health plan through our e-Commerce site and talk to us and your co-PhilCare members through our social media sites. Digital channels promote convenience and speed of service delivery to our members.

 

Hassle-Free Availment

ER Health Assist 80 does not require medical examinations (for purchase) and hospital deposit (for availment.) It is accepted in 500+ PhilCare-accredited hospitals nationwide excluding six (6) major hospitals in Metro Manila (Makati Medical Center, St. Luke's Medical Center (QC and Global), Asian Hospital and Medical Center, The Medical City, and Cardinal Santos Medical Center).

 


Outpatient Availment

 

1.    For medical consultation, create a self-issued Letter of Authorization (LOA) at the Consultations page. Just click on this link to generate LOA: https://www.philcare.com.ph/consultationcards/ .

2.    For availment of medical procedure, present this voucher together with a valid identification and the requested lab procedures to PhilCare Makati and MOA Clinics. Procedures covered are those available only to both clinics.

3.    For dental consultation, ensure to call the dentist first for available schedule prior to creating a self-issued Letter of Authorization (LOA) at the Consultation page. Just click on this link to generate LOA: https://www.philcare.com.ph/consultationcards/ .

4.    Print and present LOA together with valid identification to chosen medical specialist/dentist upon availment.



Emergency and Hospitalization Availment

1.    Simply present this voucher together with a valid identification to the emergency room personnel at the identified PhilCare-accredited hospital.

2.    ER personnel will facilitate the approval of your availment thru reaching our contact center to verify your membership eligibility and health coverage. The final medical diagnosis is the basis for PhilCare’s approval of coverage

3.    Once approval has been provided, request for cancellation of approval to reactivate membership is not allowed.



Terms and conditions apply.

** See FAQs for more details.

*** Check the list of non-covered illnesses and disease

** Your final medical diagnosis is the basis for PhilCare’s approval of coverage.

** PhilHealth is required for the availment of this card during hospital confinement.

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