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ER Health Assist 80 for Adults
ER Health Assist 80 for Adults
ER Health Assist 80 is a health plan 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.
ER Health Assist 80 for Adults is for age 18 to 65 years old and is valid for 1 year upon activation date. Benefits starts 7 days after activation date. The Certificate of Coverage is non-transferable once activated.
Outpatient Care Benefits:
One (1) year unlimited medical consultations (including pre-existing
illnesses) through the following specialists at PhilCare Makati and MOA Clinics only.
» Family Medicine, Internal Medicine, OB Gyne, Opthalmology, Dermatology & ENT
- One (1) year unlimited HeyPhil Digimed consultations.
- One (1) year standard dental coverage at Health Partners Dental provider inclusive of the following:
Standard Dental Package:
- Annual Dental Examination and Consultation
- 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
- Emergency Out-patient Dental Treatment to be availed at Health Partners dental provider
Outpatient Emergency Care and Hospitalization Care Benefits:
ER Health Assist 80 for Adults*
gives you a one-time coverage up to Php 80,000 for viral,
bacterial illnesses and treatment of injuries resulting from accidents (except for stroke)
in more than 500 accredited hospitals nationwide excluding nine (9) premium hospitals (Makati Medical
Center, St. Luke’s Medical Center in QC and Global, Asian Hospital, The
Medical City, Cardinal Santos Medical Center, Manila Adventist Medical Center, Notre Dame de Charles Hospital and Philippine Orthopedic Institute). The Coverage is inclusive of the following
- Room and board (Regular Private Room)
- Doctor's fees
- Laboratory and diagnostics procedures
- Special modalities of treatment as medically necessary during ER and confinement, subject to Php 5,000 inner limits
- Diagnostics and therapeutic procedures as medically necessary during ER and confinement
- Medicines (except vaccines) as medically necessary during ER and confinement except for cases declared as non-coverable ** , subject to standard inner limits
Other Additional Benefits (this benefit is provided by a third party-insurance provider):
- Php 50,000 accidental death and disability coverage
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. **
Client may examine and cancel this health plan within a period of 15 days from receipt of the Certificate of Coverage, provided that the product hasn’t been utilized or availed for its purpose. The membership coverage shall be terminated thereafter. Refund provisions apply in accordance to PhilCare’s Termination Policy. Please email your request at [email protected].
- For medical and dental consultation, present this COC together with a valid identification to PhilCare Makati and MOA clinics.
- Avail the consultation benefit to your preferred physician available in the clinic.
- For dental consultation, ensure to call the dentist first for available schedule.
Emergency and Hospitalization Availment:
- Simply present this COC together with a valid identification to the emergency room personnel at the identified PhilCare-accredited hospital.
- 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.
- Once approval has been provided, request for cancellation of approval to reactivate membership is not allowed.
HeyPhil Digimed Consultation Procedure:
- Download the HeyPhil DigiMed application through Play Store (for android phones) or App Store (for IPhones)
- Click Need Online Mental Counseling or Medical Consultation? Click Here found at the bottom part of the app screen.
- Go to With Reference No? Click Here found at the upper part of the app screen.
- Fill out the Patient Profile then click submit.
- Enter your Chief Complaint or the reason why would you like to seek for medical consultation.
- Attach a photo of your most recent doctor’s prescription or laboratory test results if available, otherwise, proceed to read and agree with the terms and conditions in availing a digital consultation.
- Click the Request Consultation to queue your digiconsult request with one of our DigiMed doctors.
- Stand by for your DigiMed Doctor’s call until the submitted chief complaint and copies of prescription and laboratory test results have been assessed. Please be reminded that your DigiMed Doctor calls from an unregistered number in your contact list.
- Engage with a medical tele-conferencing with your DigiMed Doctor.
- Check on the medical assessment and prescription sent to your registered email.
- Rate and send your feedback about your HeyPhil DigiMed consultation experience.
By buying, registering or availing coverage of any of the above products, I certify that I have read, understand and agree to these Terms and Conditions. I would receive the soft copy of the full policy contract within 7 business days from the receipt of the Certificate of Coverage that includes the full details of the product that I have purchased including its terms and conditions. I may also opt to request for a full policy contract by sending an email to [email protected]. If I disagree with these Terms and Conditions and I have not registered the product, I can request for a refund, subject to the PhilCare Returns & Refund or Replacement, or Cancellation Procedures (https://shop.philcare.com.ph/return-refund-terms).
I certify that the information given and to be given by me or on my behalf is true and correct and that any material misrepresentation or falsity therein shall be construed as an act to defraud PhilHealthCare Inc. (PhilCare), and serves as sufficient ground for any and all of the following actions: the rejection or cancellation of my application or membership, non-coverage of medical expenses at accredited providers, collection of receipt from me in case of payment of medical expense advanced by PhilCare. I hereby authorize PhilCare to inquire about and investigate all declared information from whatever sources PhilCare may consider appropriate.
I agree that receipt of the corresponding membership fees by PhilCare does not constitute acceptance of my application until the corresponding application has been approved. For ER Health Assist and VidaCare health plans, approval of application is automatic seven (7) calendar days from notice of successful registration. Coverage shall automatically begin, regardless of the status of receipt of notice advising the member of successful registration and coverage period. Any incident, illness or condition that occurs prior to the start of coverage, even if it continues up to or past the Effectivity Date, will not be covered.
I agree to the limitations and other exclusions applicable to health care coverage found https://shop.philcare.com.ph/non-covered-illnesses-and-diseases. PhilCare shall have the final decision to determine if the consultation service requested is caused by coverable or non-coverable condition.
I hereby agree to PhilCare in retrieving and processing any and all medical information drawn or obtained pursuant to its services based on my coverage, provided, that (a) such information shall only be utilized in accordance with lawful and official business purposes of PhilCare; (b) such information shall not be disclosed to non-essential personnel or entities; and (c) all reasonable efforts shall be taken to maintain the confidentiality of said information.
* See FAQs for more details.
*Check the list of
Non-Covered Illnesses and Diseases
***The Certificate of Coverage (COC) is issued together with the soft copy policy (provided within 7 business days from COC receipt). To request for a full hard copy policy contract, please send an email to [email protected].