Age Eligibility: 0 to 65

Outpatient Benefits

In MediCard Free-Standing Clinics:

Unlimited out-patient consultations by appointment with the following specialists:

• Family medicine specialist
• Internist
• Cardiologist
• Endocrinologist
• Pulmonologist
• Gastroenterologist
• Pediatrician
• OB-Gynecologists (except for maternity cases)
• Dermatologists – at MediCard free-standing clinic only
• Ophthalmologist
• ENT

Flat rate of PHP 500 for consult with other specialists and sub-specialists in any MediCard Free-Standing Clinic like Rehabilitation Medicine, etc.

30% discount on out-patient laboratory and diagnostic tests in any MediCard Free-Standing Clinics.

In our Accredited Network:

• Family medicine specialist
• Internist
• Cardiologist
• Endocrinologist
• Pulmonologist
• Gastroenterologist
• Pediatrician
• OB-Gynecologists (except for maternity cases)
• Ophthalmologist
• ENT

NOTE: Free consultations may be availed of starting 7 days after date of effectivity

Emergency Care Benefits

In our Accredited network:

Total limit up to P30,000 for Trauma cases which include the following:

• Vehicular accidents (vehicle registration (OR/CR) and driver’s license should be submitted)
• Burns
• Animal bites
• Accidental chemical poisoning
• Other forms of accidents not brought about by the member’s own negligence or misconduct or not brought about by acts which are against the laws of the Philippines

Note: Availing of services must be made within six (6) hours from the time of the incident.

In MediCard-accredited hospitals including 5-Star Hospitals:
Covered up to 30,000

In non-MediCard accredited hospitals:
MediCard will reimburse one hundred percent (100%) of the approved total hospital charges and professional fees based on MediCard relative value subject to applicable inner limits at non-MediCard accredited hospitals subject to the limits mentioned.

Out-patient Emergency care services for the above trauma cases will include the following:

• Doctor’s services
• Emergency medicines used during treatment or for immediate relief
  Oxygen
• Dressings, ordinary casts, and sutures
• Tetanus toxoid, anti-tetanus serum, and active immunization for rabies
• Basic laboratory, x-ray and other basic diagnostic examinations directly related to the emergency management of the patient
• CT scan, MRI and ultrasound are covered up to P5,000 each within the total limit if deemed necessary for the immediate management of the patient
• Emergency Complex Diagnostic and Therapeutic Procedures will be covered by MediCard up to P5,000 each within the total limit. The following are considered as complex diagnostic or therapeutic procedures:
  – angiography
  – pulmonary perfusion scan
  – tests involving use of nuclear technologies
  – electromyography, nerve conduction studies
  – 2D echo and Doppler
  – endoscopies including one of video
  – arthroscopies
  – adrenocortical functions
  – all other diagnostic tests and therapeutic procedures not mentioned but deemed by MediCard as a complex diagnostic and therapeutic procedure

The member may avail of emergency cases for the mentioned cases more than once as long as the limit is not fully consumed and it is still within the 6-hour period from the time of accident.

Annual Physical Exam (APE) Benefit

In MediCard Free-Standing Clinics:

One-time A.P.E. in any MediCard Free-Standing Clinics includes the following:

• General check-up
• Complete Blood Count
• Urinalysis
• Fecalysis
• Chest X-ray

Note: Availment of A.P.E. should be by appointment.

In our Accredited Network:

One-time A.P.E. in MediCard-designated accredited clinics and hospitals includes the following:

• General check-up
• Complete Blood Count
• Urinalysis
• Fecalysis
• Chest X-ray

2 options:

Up to PHP 600 – if availed in MediCard-Accredited Hospitals/Clinics (A.P.E. Endorsement Letter must be secured first from MediCard)
Up to PHP 500 – if availed in Non-MediCard Accredited Hospitals/Clinics on a reimbursement basis

NOTE: A.P.E. may be availed of starting 14 days after date of effectivity

Dental Benefits

In MediCard Free-Standing Clinics:

• Unlimited out-patient consultations with dentists
• Baseline panoramic X-Ray (valued at PHP 1,500) in MediCard Free-Standing Clinics where available. As of June 7, 2023, this is available in:
  MediCard Lifestyle Center
  Festival Mall, Alabang
  Centris, QC
  Uptown Bonifacio
  Sta. Rosa, Laguna
• One-time oral prophylaxis (mild cases only) in any MediCard Free-Standing Clinic
• 30% discount on dental procedures in any MediCard Free-Standing Clinic

In our Accredited Network:

• Unlimited out-patient consultations with dentists.
• One-time oral prophylaxis (mild cases only) in any MediCard-accredited dental clinics and hospitals.

Notes for oral prophylaxis:

For mild cases only: few tartar build-ups on surfaces of teeth and those hidden in between and under the gums.
Classification depends on assessment of the dentist.
Moderate and heavy cases are not covered.

Other Benefits:

• 30% discount on out-patient surgeries in any MediCard Free-Standing Clinic and other services such as those offered in Skin & Body Laser & Aesthetic Care Center by MediCard
• Waived medical evaluation

NOTE: All out-patient benefits mentioned above may be availed of by appointment from Mondays to Fridays in any MediCard Free-Standing Clinic.