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PhilCare Agapay 900
PhilCare Agapay 900
PhilCare Agapay900 is a health card that covers a single-use benefit up to *Php40,000 for ambulance service, out-patient emergency care and hospitalization for viral, bacterial illnesses and treatment of injuries resulting from accidents (excepts for stroke) in 500+ PhilCare-accredited hospitals.
PhilCare Agapay 900 is for age 16 to 65 years old and is valid for 1 year upon activation date. Benefits starts 7 days after activation date. The voucher is non-transferable once activated.
Outpatient Emergency Care and Hospitalization Care Benefits:
PhilCare Agapay 900
gives you a one-time coverage up to Php 40,000 for viral, bacterial
illnesses and treatment of injuries resulting from accidents (except stroke)
In more than 500 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). The Coverage is
inclusive of the following benefits:
- Room and board (Ward Room)
- Doctors’ fees
- Laboratory and diagnostics procedures
- Special modalities
of treatment as medically necessary during ER and confinement, subject to P5,000 inner
- Medicines (except vaccines) as medically necessary during ER and confinement except for cases declared as non-coverable **, subject to standard inner limits
- Diagnostic 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.
Other Additional Benefits:
Ambulance Service (Outright coverage within Metro Manila, reimbursable up to Php
5,000 when outside Metro Manila)
Emergency and Hospitalization Availment:
- Simply present this voucher 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.
- Co-pay amount of Php 5,000 kicks in first prior to PhilCare coverage on outpatient emergency care and hospitalization.
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. In lieu of the policy contract, I accept to receive a 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://philcare.com.ph/returns).
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 PhilCare Agapay and PhilCare Rush, approval of application is 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 co-pay feature of this product. PhilCare shall cover the remaining bills of the coverable case up to the plan’s benefit limit when the co-pay amount has been paid by the member.
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 is issued in lieu of the policy, as this encompasses the full details of the product purchased, including its terms and conditions. To request for a full policy contract, please send an email to [email protected].