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ER Shield is a single-use health plan that provides coverage for outpatient emergency care for viral and bacterial illnesses and treatment of injuries resulting from accidents (except for stroke) in 500+ designated PhilCare-accredited hospitals.
ER Shield is for age 6 months 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 Emergency Care:
gives you one-time coverage up to Php 50,000 for emergency care expense for viral and bacterial illnesses, treatment of injuries resulting from accidents (except for stroke) in 500+ designated PhilCare-accredited hospitals nationwide. Inclusive of doctors’ fees, laboratory and diagnostic procedures, and medicines (as
medically necessary and excluding vaccines). 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
- Special modalities of treatment as medically necessary during ER and subject to P5,000 inner limit.
- Diagnostic and therapeutic procedures as medically necessary for emergency room care.
- Hospital emergency care for animal bites except vaccines.
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].
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.
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 24 hours 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 Shield and ER Vantage Plus, and Health Vantage approval of application is seven (7) calendar days from notice of successful registration. For Dengue Assist, approval of application is automatic thirty (30) 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 coverage of illnesses as stated in the general exclusions applicable to health care coverage found in https://shop.philcare.com.ph/non-covered-illnesses-and-diseases. PhilCare shall have the final decision to determine coverage of illness based on but not limited to registration date, start date of coverage, final diagnosis, general exclusions, evaluation of the case as emergency in nature, hospital billing, and professional fees.
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 24 hours from COC receipt). To request for a full hard copy policy contract, please send an email to [email protected].