MyMaxicare - Family

My Maxicare Family Program Health Insurance offers great deals on family medical coverage, made affordable to best suit your budget. This type of HMO insurance plan is designed to protect your family's health from high medical costs when unexpected emergency or accident arised. Medical insurance plan includes basic hospital benefits, comprehensive coverage for out-patient benefits, hassle-free procedure for in-patient (simply swipe the card), and covered by top hospitals in the Philippines. Have peace of mind knowing your love ones are well taken care of.

Looking for other HMO insurance options? You may want to check out other health insurance plans here.

MyMaxicare - Family

Affordable family health insurance policy with My Maxicare Family. Compare premiums and coverage online. Get free insurance quotes now.

Key Benefits

  • My Maxicare Family covers in-patient and out-patient care, preventive care and emergency care benefits
  • Flexible payment of membership fees (annual, semi-annual, quarterly) basis
  • Access to over 56,000 top-calliber medical specialists and affiliated doctors and more than 1,000 accredited hospitals and clinics in the country

Overview

Product Name
MyMaxicare - Family
Coverage Area
Local

Coverage Plans

Plan Type Maximum Benefit Limit Room Type Remarks
Platinum Plus PHP200,000.00 Large Private Platinum Plus
Platinum PHP150,000.00 Regular Private Platinum
Gold PHP100,000.00 Regular Private Gold
Silver PHP60,000.00 Semi Private Silver

Coverage Details

Benefit Type Cover Deductible Remarks
Room and Board Included N/A N/A
Use of Operating Room Included If prescribed by an attending Accredited Physician N/A
Intensive Care Unit, Isolation Room Included N/A N/A
Professional Fees Included N/A N/A
Surgeons Fee Included N/A N/A
Anaesthetist's Fee Included N/A N/A
Standard Nursing Services Included N/A N/A
Medicines for in-patient use Included N/A N/A
Blood Transfusion and intravenous fluids Included N/A N/A
Diagnostic, X-rays and Laboratory Tests Included N/A N/A
Dressings, Conventional Casts and Sutures Included N/A N/A
Anesthesia and its administration Included N/A N/A
Oxygen and its administration Included N/A N/A
Standard admission kit Included N/A N/A
Other items directly related in the medical management of the patient Included As deemed medically necessary by the attending Accredited Physician N/A
Consultation during regular clinic hours Included N/A N/A
Eye, ear, nose and throat (EENT) treatment Included N/A N/A
Treatment of minor injuries such as lacerations, mild burns, sprains, and the like Included N/A N/A
Dressings, Conventional Casts and Sutures Included N/A N/A
Diagnostic, X-rays and Laboratory Tests Included N/A N/A
Minor surgery not requiring confinement Included N/A N/A
Eye Laser Theraphy (retinal tear/detachment.glaucoma) Included Up to PHP10,000 per eye per member per year As prescribed by an Accredited Physician
Electrocauterization of skin lesions Included Up to PHP1,000 per member per year As prescribed by an Accredited Physician
Sclerotheraphy for varicose veins Included As prescribed by an Accredited Physician, up to PHP5,000 per leg per member per year Except medicines and for cosmetic purposes
Allergy Testing Included Up to PHP2,500 per member per year As prescribed by an Accredited Physician
Speech Theraphy (for Stroke patients) Included Up to PHP10,000 per member per year, reimbursement basis As Charged
Tuberculin Testing Included Up to PHP600 per member per year N/A
Emergency Care Included Subject to condition if Non-Accredited Hospital As Charged if Accredited Hospital
Emergency Local Ambulance Service Included Up to limit and PHP2,500 per condition if non-accredited hospital, reimbursement basis From accredited hospital to accredited hospital
Preventive Care Benefit Included N/A N/A
Passive and active vaccines for treatment of tetanus and animal bites Included Up to PHP18,000 per member per year Included
Periodic monitoring of health problems Included N/A N/A
Health education and counseling on diets and exercise Included N/A N/A
Health habits & Family planning counseling Included N/A N/A
Annual Physical Examination Included N/A N/A
Dental Care : Annual Fee Included PHP387.00 OPTIONAL
Life Coverage with accidental death and dismemberment Included Up to PHP25,000 N/A
Scoliosis treatment Included Up to PHP20,000 per member per year N/A
Congenital treatment Included Up to PHP20,000 per member per year N/A
Physical therapy/ Occupational therapy Included Up to limit N/A
Consultation for Chronic Dermatoses Included Up to limit per year N/A
Emergency Out-Patient Included N/A N/A
International emergency assistance Included Hotline: (632) 3282460 via CHUBB
Emergency Medical Accident Assistance Services Included N/A N/A
Coverage for Dreaded Conditions Included N/A Depend on Type of Plan
Dental Care : Semi-Annual Fee Included PHP209.00 OPTIONAL
Dental Care : Quarterly Fee Included PHP108.00 OPTIONAL

FAQs

Who can be covered by My Maxicare Family?

My Maxicare Family covers individuals aged fifteen (15) days old to sixty (60) years and five (5) months old.

What are the requirements needed when applying for My Maxicare Family?

For couples

  • Application form
  • Copy of Marriage Certificate
  • Medical Requirements (applicable for enrollees aged 49 years old above)
  • Photocopy of Alien Certificate of Residency (for foreign nationals)

With child dependent

  • Application form
  • Copy of Birth Certificate per child
  • Medical Requirements (applicable for enrollees aged 49 years old above)
  • Photocopy of Alien Certificate of Residency (for foreign nationals)

What does a My Maxicare Family cover?

As one of the leading HMOs in the Philippines, My Maxicare Family covers in-patient care, out-patient care, preventive care, and emergency care benefits.

What are the steps in filing reimbursement from a non-affiliated facility during an emergency case?

To file for reimbursement, present the following documents:

  • Completely filled-out Claims Reimbursement form
  • Original Official Receipt/s of the hospital bills, which includes the Statement of Account (SOA) and charge slips
  • Clinical Abstract of the case (if a surgical procedure was performed) and a hispathological report
  • Operative Record of the case/treatment or admission/discharge record signed by the attending physician

What is an example of an emergency condition?

A medical case is considered an emergency condition when it is life-threatening, an accidental injury, or an unexpected onset of a health condition, such as heart attack, cardiovascular, and loss of consciousness.

Does My Maxicare Family cover dreaded and non-dreaded conditions?

Yes, this type of health plan covers dreaded and non-dreaded conditions up to a certain amount and depends on when the health insurance coverage starts.

How do I know if I’ve consumed my Maximum Benefit (MBL)?

You can log in on the Maxicare Member’s Gateway to check your Maxicare health card transaction history. You must register first before you can view your information.

Apply for this insurance, or compare with others.

Compare with others