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Executive / Executive Elite

HEALTH CARE PROGRAMS ESPECIALLY TAILORED
FOR EXECUTIVES AND PROFESSIONALS


The Classic Executive Program offers a wide range of health care coverage as well as special services and amenities to specifically address the needs of young professionals and junior executives.

As our valued member, you have the point-of-service option benefit or the partial reimbursement of medical expenses incurred under a non-affiliated doctor or hospital whether emergency or non-emergency in nature. These services may be availed of locally.

PhilCare designed the Classic Executive Elite Program to answer the need of clients for a wider range of health care coverage as well as special services and amenities that they might need.

The Classic Executive Elite Program grants high-end clients an array of perks including high benefit limits, offshore treatment and a more extensive out-patient executive check-up package.

Both Programs include access to Cardinal Santos Medical Center, Makati Medical Center, St. Luke's Medical Center (Quezon City), and The Medical City, EXCEPT Asian Hospital and Medical Center and St. Luke's Medical Center-Global City.


BENEFITS:

  Classic Executive Classic Executive Elite
Plan Variant Executive 150 Executive 250 Executive  Elite Private Executive Elite Suite
Room Type PRIVATE PRIVATE PRIVATE SUITE
Daily Room Rate OPEN OPEN OPEN P  2, 500
Annual Benefit Limit (one limit for all illness per year) P  150, 000 P  250, 000 P  500, 000 P  1 Million
Special modalities of treatment
Up to Plan Limit
APE Package
 Executive Check-up feature Executive check-up feature
with treadmill

 Note: This health care program does not cover pre-existing and congenital conditions



Annual Executive Check-up Package (Out-patient) at PhilCare and designated clinics
>    Review of Medical History
>    Physical Examination
>    Chest X-ray
>    Urinalysis
>    Fecalysis
>    Complete Blood Count (CBC)
>    ECG for 35 years old & above
>    PAP Smear for all females 35 years old & below
>    Fasting Blood Sugar (FBS)
>    Blood Urea Nitrogen (BUN)
>    Cholesterol
>    Creatinine
>    Triglyceride
>    Low Density Lipoprotein (LDL)
>    High Density Lipoprotein (HDL)
>    TREADMILL TEST (for Executive Elite Program only)

Out-patient Services
>    Consultations, including specialists' evaluation
>    First aid treatment of injury or illness
>    Emergency medicine for the immediate relief of symptoms
>    Necessary x-ray, laboratory and other diagnostic exams
>    Minor surgery not requiring confinement
>    Eye, ear, nose, and throat (EENT) care
>    Pre-natal and Post-natal consultations at PhilCare clinics

In-patient Services (Hospitalization)
>    Services of a Physician including surgical services
>    Room and Board according to the type of room accommodation and subject to the maximum rate of
          Daily Room and Board as stated in the Member's Benefit Schedule
>    General Nursing Service
>    Use of operating room and recovery room
>    Anesthesia and its administration
>    Drug and medication during confinement
>    Confinement in Intensive Care Unit up to the maximum benefit limit
>    Other services deemed medically necessary such as but not limited to:
      o    Oxygen and its administration
      o    Dressings, plaster casts and other medical supplies
      o    Laboratory tests, x-rays and other necessary diagnostic services
      o    Blood and other blood elements transfusion including screening and cross-matching subject to
                General Exclusions.
      o    Dialysis, chemotherapy and similar treatment procedures except occupational therapy up to the
                maximum benefit limit.

Preventive Health Care
>    Administration of vaccine (excluding the cost of vaccine & determination of susceptibility)
>    Consultations and advice on diet, exercise & other healthful habits
>    Periodic monitoring of health problems
>    Family planning counseling

P100,000 Term Life Insurance

P100,000 Accidental Death & Disablement

Special Modalities of Treatment
PhilCare offers coverage of special modalities of treatment such as Laparoscopic Cholesystectomy*, Lithotripsy*, Magnetic Resonance Imaging (MRI) and Nuclear Radioactive Isotope Scan, etc. up to the Maximum Benefit Limit.

*The availment of Laparoscopic Cholesystectomy and Lithotripsy is limited only to once per contract year. When you choose these modalities of treatment, PhilCare shall no longer be liable for the cost of further traditional mode of treatment/diagnostic tests for the same illness should be necessary.


Point-of-Service Option
You can avail the services of non-affiliated doctors and/or non-affiliated hospitals in the Philippines for of hospitalization benefits, whether emergency or non-emergency. With this, you may avail your hospitalization benefits even without authorization from PhilCare as long as the hospitalization is prescribed by a qualified physician.

For out-patient benefits, you may go directly to any specialist even without prior authorization from PhilCare. Laboratory or diagnostic exams, however, must be done in a PhilCare clinic.

Note: In any of the above cases where the services were rendered by a non-affiliated provider or there was no prior authorization from PhilCare, you will have to advance the payment to the doctor and hospital. You may also be charged by the doctor according to the doctor's private fees. You shall then be reimbursed 80% of the health care expenses that you incurred but not to exceed 80% of what PhilCare would have paid had you been treated by an affiliated physician in an affiliated hospital.




Care in Foreign Territories (for Executive Elite Program only)


Emergency Care
If you are confined or treated in a hospital outside the Philippines due to an emergency, PhilCare shall reimburse you up to 80% of the reasonable and coverable charges for medical care and services which are incurred as a result of such emergency. However, this should not exceed what PhilCare would have paid had you been treated by an Affiliated Physician in an Affiliated Hospital in the Philippines of P50,000.00, whichever is less.

Optional Dental Benefits

Package 1 - (Standard Package)

>   Annual dental examination and consultations
>   Emergency out-patient dental treatment to be availed at accredited dental clinics only
>   Oral Prophylaxis once a year (light cases only)
>   Simple tooth extractions
>   Restorative and prosthodontics treatment planning
>   Temporary fillings - unlimited as needed
>   Desensitization of hypersensitive teeth
>   Recementation of loose crowns, inlays and onlays
>   Dental Nutrition and dietary counseling
>   Dental Health education
>   Pre-natal check of teeth and gums
>   Temporo mandibular joint consultation
>   Gum treatment for cases like inflammation or bleeding

Package 2 - Package 1 + 2 lightcure surfaces

Package 3 - Package 2 + 1 additional Prophylaxis


ENROLLMENT FEES (additional cost per member)
 
Executive 150Executive 250Executive  Elite PrivateExecutive Elite Suite
IndividualP   250P   250P   975P   1,875
FamilyP   420P   420P   1,875P   3,675


DENTAL FEES:  (additional cost per member)

Package 1
Package 2
Package 3
AnnualP   240
P   440
P   520
Semi-AnnualP   120
P   220
P   260
QuarterlyP   60
P   110
P   130
Monthly
P   20P   40
P   45