Maxicare Starter Plan

Maxicare continues to reach out to provide quality healthcare to more Filipinos by offering products that will fit the needs and demands of the market. The Maxicare Starter Program has been launched by Maxicare to cater to small businesses and provide its employees a high quality, full coverage HMO plan. It is a Full Risk, Full HMO product that caters to Corporate Accounts with at least 3 to 9 enrollees and their dependents (Total headcount should not exceed 99 enrollees). The Starter Plan will give the members extensive access to their needed medical services at all Maxicare accredited hospitals nationwide. Whether you are a start – up business with limited number of employees, you can and should secure your employees’ health.
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Plan Type

Room & Board

Maximum Benefit Limit (MBL)

Platinum 1

Small Suite

220,000

Platinum 2

Large Private

175,000

Gold 1

Regular Private

150,000 

Gold 2

Regular Private

100,000

Silver 1

Semi Private

80,000

Silver 2

Semi Private

60,000

Bronze

Ward

50,000

Health Benefits

Out-Patient Care
  • Consultation
  • Treatment of minor injuries such as lacerations, mild burns, sprains and the likes
  • Minor surgery not requiring confinement
  • Eyes, ears, nose, throat (EENT) treatment
  • Eye laser therapy for retinal tear, retinal hole, retinal detachment and glaucoma
  • X-ray, laboratory exams, routine and diagnostic procedures as prescribed by an accredited Physician
  • Cauterization of warts
  • Sclerotherapy for varicose veins
  • Allergy-testing, allergy screening and other related examinations
  • Speech Therapy (For Stroke patients only)
  • Tuberculin Test
In-Patient Care
  • Room and board accommodation
  • Use of operating room, intensive care unit (ICU), isolation room, recovery room
  • Professional Fee/s of the attending Physician/s
  • Prescribed drugs and medicines for use in the hospital
  • Whole blood / human blood products and IV fluids transfusion
  • X-ray, laboratory tests, diagnostic tests and therapeutic procedures incidental to confinement
  • Dressings, conventional casts and sutures
  • Anesthesia, Oxygen and its administration
  • Standard nursing services and admission kit
Emergency Care

A. Maxicare – Affiliated Hospitals

  • Doctor’s services
  • Emergency Room fees
  • Medicine used for immediate relief and during treatment
  • Oxygen, IV fluids, whole blood and human blood products
  • Dressings, casts and suture
  • X-ray, laboratory and diagnostic exams, and other medical services related to the emergency treatment of the patient
  • Room upgrade in case of room unavailability
  • Initial treatment of animal bites – covered for the first 24 hours from the time of bite
  • Ambulatory Service from affiliated hospital or clinic to another affiliated one covered up to benefit limit

B. Non-Affiliated Hospitals

  • Within the Philippines

– Reimbursable up to 80% of total hospital bills and Professional fees, up to Php 30,000.00 per case during the first 24 hours

  • Areas within the Philippines without Maxicare – affiliated hospital

– Reimbursable up to 100% of total hospital bills and Professional fees

  • Outside the Philippines

– Reimbursable up to 100% of the total hospital bills and Professional fees

  • Ambulatory service

– From non-affiliated hospital or clinic to an affiliated one covered up to Php 2,500 per conduction

Preventive Care
  • Passive and active vaccines for treatment of tetanus and animal bites
  • Periodic monitoring of health problems
  • Health education and counseling on diet or exercise
  • Health habits and family planning counseling
Other Benefits
  • Pre-existing dreaded and/or non-dreaded conditions
  • (Principals only) Work-related cases
  • Diagnostic procedures
  • Provoked and unprovoked assault
  • Account size – Minimum of 3 up to maximum of 9 principals
    – Maximum of 99 enrollees (combination of principals and dependents)
    Age Eligibility
    – Principals: 18 to 65 years old
    – Adult Independents: 18 to 65 years old
    – Minor Dependents: 15 days to 21 years old
  • Submission of Application Form is not required
  • Membership fees can be paid on an annual and semi-annual basis
  • All benefits are subject to Maxicare’s General Exclusions and Conditions for eligible accounts

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