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These hospitalization benefits shall be available
subject to the following conditions except for emergency illness or
injury wherein the Emergency Benefits provision of the Agreement
shall apply:
-
The hospitalization must be arranged or
approved by the Philamcare authorised personnel prior to the
confinement.
-
The confinement shall be in an affiliated
hospital and the type of hospital room accommodation shall be in
accordance with the Member's benefit classification and maximum
rate allowance.
-
Professional services shall be provided
only by Philamcare physician(s) or affiliated physician(s).
-
If discharge from the hospital has been
authorised by a physician and the member fail or refuse to do
so, Philamcare shall not be responsible for any charges for
hospital services rendered after the day and time for which
discharge has been authorised.
Latest Modalities of Treatment and/or Diagnosis tests
| Laparoscopic
Cholecystectomy |
P35.000 |
| Lithotripsy |
30,000 |
| MRI |
5,000 |
| Nuclear
or Radioactive Isotope Seams |
5,000 |
| Laparoscopic
Myoma Resection |
20,000 |
| Laparoscopic
Adrenalectomyl |
|
| Unilateral |
75,000 |
| Bilateral |
85,000 |
| Transurethal
Microwave Theraphy of Prostate |
30,000 |
| Hysterospically-guided
Biopsy/D and C |
10,000 |
| Percutaneous
Ultrasonic Nephrolithotomy |
40,000 |
| Ureterolithotripsy................................Lithotripsy
limit + |
5,000 |
| Stereostatic
Brain Biopsy |
120,000 |
| Cryosurgery |
1,000/area |
| Sleep
Study and Neuroscan |
5,000 |
| Sclerotheraphy
(for various veins) |
5,000 |
| Pelvic
Laparoscopy (for endometriosis) |
22,500 |
| All new
modalities of treatment and/or diagnosis for which there are
no comparable conventional or traditional equivalents or
counterparts |
5,000 |
|
|
| * or up
to the maximum limit of the plan, whichever is lower |
|
|
Standard
Plans for Individuals and Families
Without
Dental Coverage and Group Life/AD&D Coverage |
|
Type of Plan
|
Diamond 1000 |
Emerald 800 |
|
Room
Accommodation
|
Private |
Semi-Private |
|
Daily Room and Board
|
P1,000 |
P800 |
|
Max. sum per
ordinary illness &/or non-ICU cases
|
No
limit |
| Max. sum per dread disease
&/or ICU cases |
|
|
P500,000
|
P100,000 |
|
Enrolment
Fees
|
|
Individual
|
P300 |
P150 |
|
Family
|
P600 |
P300 |
|
Baby
Group
|
P500 |
|
Optional
Rider (additional cost)
|
|
Mode of Payment
|
Dental Fees
|
P10,000
term life and P10,000 AD&D coverage
|
|
Annual
|
P150.00 |
P62.00 |
|
Semi-Annual
|
P75.00 |
P34.00 |
|
Quarterly
|
P37.00 |
P18.00 |
Note: Dread diseases
include neurological diseases, blood dyscrasias, collagen/immunology
disorders, liver cirrhosis, pulmonary/renal diseases, chronic
endocrine diseases including diabetes mellitus, cardiovascular
diseases, cancer, any condition that will necessitate the use of ICU
and accidental injuries.
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