FAQs

FAQs

EMERGENCY PREPAID HEALTH PLANS

Question What are ER Shield, ER Vantage Plus, and Health Vantage Programs?
Response: ER Shield and ER Vantage Plus are one-time use emergency health plans while Health Vantage is a multiple-frequency of availment emergency plan.
Additional Information: ER Shield ER Shield program provides coverage for outpatient hospital emergency care up to Php 50,000 for a Php 800 premium only
Additional Information: ER Vantage Plus ER Vantage Plus program provides coverage for hospital emergency care leading to admission. It could also be used just for hospital outpatient emergency care. There are 3 variants of ER Vantage Plus that one can choose depending on his/her needs: ER Vantage Plus 40, ER Vantage Plus 60, and ER Vantage Plus 80. Depending on the age of the enrollee, the ER Vantage Plus costs:

 

Question What are the coverable cases for ER Shield, ER Vantage Plus, and Health Vantage?
Response:

Depending on the program’s service coverage, the following are the covered conditions:

  • Accidents, excluding Cerebrovascular (Stroke)
  • Acute Appendicitis
  • Acute Bronchitis
  • Acute Gastritis
  • Acute Gastroenteritis
  • Acute Pharyngitis
  • Acute Sinusitis
  • Acute Tonsillitis
  • Acute Upper Respiratory Tract Infection
  • Amoebiasis
  • Cellulitis
  • Dengue
  • Fracture, new
  • Acute Pneumonia
  • Sprain
  • Typhoid Fever
  • Upper Respiratory Tract Infection
  • Urinary Tract Infection
  • Viral Infection
Additional Information Accidents except for cerebrovascular accidents (stroke) and injuries suffered because of a member’s misconduct,voluntary participation in hazardous sport or activity and military service or under conditions of war.

 

Question Are all expenses incurred in the hospital covered?
Response:

For conditions that can be covered, ER Shield plan provides coverage up to Php 50,000 for the following:

  • Hospital emergency room care
  • Treatment for animal bites except cost of vaccines
  • Diagnostic and therapeutic procedures that are medically necessary for emergency room care
Additional Information Special modalities of treatment such as Magnetic Resonance Imaging (MRI) is subject to Php 5,000 inner limit. ER Vantage Plus and Health Vantage plans, depending on the chosen variant, provides coverage of hospital emergency room care plus expenses for the room and board, diagnostic and therapeutic procedures as medically necessary during confinement up to the plan aggregate limit. Special modalities of treatment is also subject to Php 5,000 inner limit.

 

Question What if the total aggregate limit will not be consumed totally, can I again use the plan in the future?
Response: The ER Shield and ER Vantage Plus are for one-time use only, regardless if the total aggregate benefit limit is consumed or not. The advantage of ER Shield and ER Vantage Plus plans is that, for a very affordable amount, you are assured of assistance, for the big portion of the hospital emergency care expenses, if not all, that you will incur.

 

Health Vantage plan, on the other hand, has no limit on the number of times you use the plan within a year as long as the aggregate benefit is not yet consumed.

 

Question Do I need to have a PhilHealth for ER Shield, ER Vantage Plus, and Health Vantage programs?
Response: For ER Shield plan, PhilHealth is not required. However, for ER Vantage Plus and Health Vantage, once there is an admission, a PhilHealth coverage is required.

 

For those who do not have PhilHealth coverage, one may just pay the PhilHealth portion of the hospital bill before discharge.

 

Question Who are qualified to have an ER Shield, ER Vantage Plus and Health Vantage programs?
Response: It is so convenient to have an ER Shield, ER vantage Plus, or Health Vantage plan. The only membership requirement is the age. For ER Shield and ER Vantage Plus, individuals must be 6 months to 65 years old from the plan’s effectivity (7 days from registration date). Registration can be done online. For Health Vantage, individuals must be 6 months to 65 years old to be enrolled under these programs.

 

Question Once I register an ER Shield or ER Vantage Plus, can I already use it?
Response: No, you can use your ER Shield or your ER Vantage Plus emergency health plan, 7 days from registration date. That is why it is important to immediately register your ER Shield or ER Vantage plan once you get it.

 

Question When can I start using my Health Vantage plan?
Response: You can start using your Health Vantage plan seven (7) days from date of completion of payment and registration.

 

Question Once I register an ER Shield or ER Vantage Plus, can I already use it?
Response: There is no limit on the number of plans that you may register in your name within a year. However, you can only register the second plan after the first plan is availed. Meaning there should only be one active plan at any given time.

 

Question Can I only enroll once under the Health Vantage program?
Response: Yes, you can only enroll once under the Health Vantage program per year, even if your aggregate benefit limit was already consumed.

 

Question Can I register/apply an ER Shield, ER Vantage Plus, or Health Vantage plan for another person?
Response: Yes, you may, as long as you know their personal data required for the registration/application.

 

Question How long will the ER Shield, ER Vantage Plus, and Health Vantage be effective?
Response: You may use the plan within one year from the start of plan effectivity.

 

Question Is ER Shield or ER Vantage Plus transferable?
Response: As long as it is not yet registered, the ER Shield and ER Vantage Plus are transferable. That is why one can purchase the plans for gifts or corporate giveaways.

 

Question Can I use the ER Shield, ER Vantage Plus and Health Vantage in hospitals not included in the plan’s provider list?
Response: No, services can only be availed in the designated hospitals. We have already made arrangements with the hospitals regarding the procedures for accepting the plans and provision of services.

 

There are more than 550 hospitals nationwide where you may avail the services for ER Shield, ER Vantage Plus, and Health Vantage.

 

Question Can I use the ER Shield, ER Vantage Plus and Health Vantage in hospitals not included in the plan’s provider list?
Response: Non-emergency, pre-existing, congenital, maternity related and those conditions under PhilCare’s general exclusion list will not be covered.

 

An illness or condition is considered pre-existing if prior to the effective date of health coverage the pathogenesis of such illness or condition has started, whether the member is aware or not.

 

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:

  • Massive Bleeding
  • Acute Appendicitis
  • Fractures/multiple injuries secondary to accidents
  • Convulsions
  • Illnesses or conditions resulting in moderate or severe dehydration such as diarrhea or fever
  • Syncope

 

Question Is ER Shield or ER Vantage Plus transferable?
Response: The following are the diseases and conditions in which the emergency and hospitalization health plans cannot be used. No health care benefits shall be paid for the following services, procedures or conditions. This is not a complete list of non-covered illnesses and diseases. PhilCare reserves the right to have the final interpretation of all definition, provisions and articles relating to the health plans. (See List A and B)

A. List of diseases not covered but not limited to:

 

B. General exclusions applicable to health care coverage:

 

UNLI-CONSULT PLANS

 

Question What are the benefits of the unli-CONSULT plans?
Response: The PhilCare unli-CONSULT plan allows you to avail of unlimited outpatient consultation services for 12 months from its nationwide network of medical specialists and dentists.

 

Question Can I use it when I am hospitalized?
Response: No, the consultation plan is only for outpatient consultation. You can seek outpatient consultation from PhilCare-accredited physicians you can find here: www.philcare.com.ph/consultationcards

 

Question Is it transferable?
Response: The consultation plan is not transferable once successfully registered. The name that has been entered during registration will be the recognized PhilCare member.

 

Question How do I register my plan?
Response: Registration can be done online via http://bit.ly/PhilCarePrepaidRegistration. Coverage is effective three (3) calendar days from registration date. By registering, you agree to the terms and conditions governing the use of the Philcare Consultation plan.

 

Question When will the one year coverage start?
Response: The count of one (1) year starts once plan is activated. Plan is activated three (3) days from registration date.

 

Question How would I know if I was able to successfully register?
Response: Once the PhilCare system receives your registration, you will receive an email confirmation informing you on the status of your registration and if there is a concern in the data you entered.

 

Question When can I avail the consultation service?
Response: After three (3) calendar days from date of successful registration, you can already avail of consultation services.

 

Question What is the procedure for availment of the consultation services?
Response: Set an appointment with the doctor via phone call prior to your day of visit to ensure accommodation. You have to present a Letter of Authorization (LOA), personalized member card and one (1) valid ID to the doctor on the day of availment.

 

Note that consultation must be availed within the LOA validity period which is within three (3) calendar days starting from the day of issuance and must be provided by the doctor indicated in the LOA.

 

Question How do I get a LOA?
Response: It is very convenient for you to get a LOA. You just self-generate it from the PhilCare website. You can do it in your most convenient time and day. Here are the steps to get a LOA:

 

Step 1 : Go to www.philcare.com.ph/consultationcards and click request for LOA. Input your certificate number provided to you upon online registration. Include also your birthdate and birthplace.
Step 2 : Select your choices of area, hospital/clinic, specialization and doctor
Step 3 : Download and print the LOA and your personalized membership card

 

Question Can I avail of medical services without a LOA?
Response: No, you cannot avail of the consultation service without a LOA. The LOA is the document that would inform the doctor that you have been authorized by PhilCare to have a consultation service.

 

You have to submit the 2 copies of the LOA to the doctor. He will forward one copy to PhilCare for his professional fee to be processed and paid. And the other copy of the LOA is for his reference.

 

Question Do I need to generate a LOA every time I will avail of a consultation service?
Response: Yes, a new LOA should be downloaded for every consultation service. An approval code will be indicated by the system per LOA extracted. The approval code indicates that PhilCare allows you to have the consultation service.

 

Question Is there a limit on how many consultations I can avail within a day?
Response: There is no limit on how many consultations you can avail in a day. You just need to generate separate LOAs for the consultation services you would need.

 

Question Can I get LOA from PhilCare offices and PhilCare clinics?
Response: We designed that LOA should be self-generated for it to be very convenient for you.

 

Please call our Customer Service Hotline at +63 (02) 8462-1800; for outside Metro Manila (toll-free for PLDT): 1-800-1888-3230 for assistance if there is a concern on downloading an LOA. PhilCare offices and clinics will only issue an LOA if the PhilCare website system is down, otherwise LOA must be self-generated.

 

Question Can I avail of any consultation service?
Response:

Enjoy the perks of all-around health and wellness by using it for regular check-ups or monitoring of existing conditions except for ENTconsultations, consultations relating to maternity-related cases and cases related to all forms of behavioral disorders, developmental, psychiatric disorder and psychosomatic illness, whether congenital or acquired.

 

Unli-Consult for 65+ health plan allows you to avail unlimited consultation services for one (1) year from PhilCare-accredited family medicine specialists, internal medicine specialists, cardiologists, endocrinologists, nephrologists, pulmonologists, gastroenterologists and dentists nationwide and one (1) year unlimited HeyPhil Digimed consultations.

 

Unli-Consult for Adults health plan allows you to avail unlimited consultation services for one (1) year from PhilCare-accredited network of medical specialists, cardiologists, endocrinologists, nephrologists, pulmonologists, gastroentrologists nationwide and dentists nationwide and one (1) year unlimited HeyPhil Digimed consultations.

 

Unli-Consult for Kids health plan gives you a one (1) year unlimited medical consultations to PhilCare-accredited with 9,600+ PhilCare-accredited pediatricians nationwide and dental consultations with PhilCare’s network of dentists and one (1) year unlimited HeyPhil Digimed consultations.

 

Question What is the procedure I need to follow for the dental consultation?
Response: For the dental services availment, you just download and print the personalized consultation card and present it together with one valid ID to the dental clinic on the day of availment. Same procedure applies as in medical consultation, we advise you to set an appointment with the dentists.

 

Question Can I also request for other services example laboratory examinations etc.?
Response: The consultation plan covers only the consultation fee. Other services will not be paid by PhilCare.

 

Question Do I need to pay any additional amount to the doctor if I just requested for consultation services?
Response: The consultation plan covers only the consultation fee. Other services will not be paid by PhilCare.

For prepaid product inquiries, email [email protected]

For prepaid product issues and concerns, email [email protected]

 

 

CAREER OPPORTUNITIES

 

Question How can I become an accredited PhilCare agent?
Response: To be accredited, you must attend the Training Seminar for Agents, which are scheduled by our Training Specialist. On the day of training, please bring the following accreditation requirements:
  • Resume
  • Photocopy of 2 Valid IDs
  • 2 pcs 2X2 ID photo
  • 2 pcs 1X1 ID photo
  • Accreditation fee of Php 999.00

 

Question How to apply for job opening?
Response: You may directly inquire and send your resume to [email protected] or [email protected] or call our HR department at (02) 8802-7333 local 18242.

 

 

PROVIDERS

 

Question How do I become an affiliated doctor of PhilCare?
Response: In order to be part of PhilCare’s affiliated network of physicians, we require you to submit the following updated documents:
  1. Letter of Intent
  2. PhilHealth Professional ID
  3. Diplomate or Fellowship Certificate from your specialty society
  4. BIR Certificate of Registration (Form 2303)
  5. Professional Regulatory Commission (PRC) ID
  6. Curriculum Vitae
  7. Your contact information including mobile and email

 

Question How can my clinic or hospital become an accredited provider of PhilCare?
Response: In order to be part of PhilCare’s accredited network of providers, we require you to submit the following updated documents:
  1. Letter of Intent
  2. DOH License to Operate (If clinic, all applicable like: lab, x-ray, drug test, dialysis, ambulatory surgical, etc.)
  3. PhilHealth Certificate (if applicable)
  4. BIR Certificate of Registration (Form 2303)
  5. SEC / DTI Registration (whichever is applicable)
  6. Business Permit
  7. Hospital/Clinic Profile
  8. Vicinity Mapwith Longitude and Latitude (Google Map will do)
  9. List of Services Available with HMO and cash basis rate
  10. List of Active Physicians with specialization, clinic schedule and contact details (mobile and email)
  11. Your Hospital/Clinic Contact Person and contact details (mobile and email)
  12. Name/s and designation/s of your signatory/ies with attached valid ID

 

Network Management Department

  1. Our Network Management Department handles the affiliation of physicians and providers (hospitals, clinics, etc.).
  2. As such, please address your letter of intent to:

     

    Network Management Department
    PhilHealthCare, Inc. (PhilCare)
    5/F STI Holdings Center,
    6764 Ayala Avenue, Makati City

     

  3. Due to the current situation, we encourage that you submit the documents through email using the email subject: "Request for Affiliation: [Name of Hospital / Clinic / Physician]"
  4. We will respond to you within three (3) working days upon our receipt of your documents or communication.
  5. All affiliation related communication should be sent to our email address, [email protected]. For further inquiries, you may also email us or call us at (02) 8802 7333 local 17084 / 17087.

 

Note: How to get latitude and longitude http://bit.ly/getlatlong