HMO PLANS

Maxicare: Covered if symptomatic with a doctor’s request; screening tests not covered.

Philcare: Covered if not for screening and with the doctor’s request.

Intellicare:

• Inpatient – Covered if symptomatic, test prescribed, and confinement required in an accredited hospital.

• Outpatient – Covered if symptomatic, test prescribed by an accredited doctor, done in an accredited facility.

Covered in the first year but with limited benefits; dreaded illnesses have annual limits.

Yes, if there is a doctor’s request.

Yes, as part of preventive health benefits.

Go to an accredited hospital, request LOA (via HMO app, Concierge Desk), present HMO/digital card & valid ID.

Use a virtual card (via app) or provide a card/policy number.

No, both must be accredited (except emergencies).

Yes, but only for emergency cases.

Documents as listed in Claims Reimbursement Form (varies per availment)

• Maxicare: 30 days; 
• Philcare: 60 days; 
• Medicard: 30 days; 
• Intellicare: 30 days.

• HMO: - Cashless, convenient, especially outpatient, accredited network only.

                          - Limited coverage, 100K-300K only.

• Medical Insurance:  Higher coverage, Flexible availment, either cashless or via reimbursement, broader network, more affordable than HMO.

• Pacific Cross: 15 days – 100 yrs.
• AXA: 15 days – 70 yrs. Renewable up to 99 years

Yes, dependents can be enrolled under the principal.

₱500,000 per year.

Yes, depending on the plan (Peso Plan subject to limits).

Not covered if the illness existed prior to the effective date.

Yes, if with the doctor’s request & pre-approval and the illness was not part of the exclusion of the policy.

Yes, if medically necessary & pre-approved.

No, excluded.

No, not allowed.

Due to the age bracket, general price increase, and/or loss ratio.

Yes, but it is subject to yearly evaluations.

Yes, upon renewal (subject to underwriting).

Compulsory Third Party Liability; required by law for LTO registration; covers third-party death/bodily injury (₱200,000 limit).

No, only persons.

Confirmation of Cover – proof of CTPL for LTO.

Provides coverage for third-party injury or death per person, without the need to establish fault.

Collision, fire, theft, malicious acts, transit damage.

The deductible is the insured’s financial participation in a claim, payable before the insurer provides any indemnity.

Proceeds go to the insured’s estate or closest relative under succession law.

May offer worldwide coverage if specifically requested.

Not automatic; requires underwriting approval.

Fire & Lightning.

Flood, Typhoon, Earthquake, Robbery, Explosion, Smoke, Vehicle Impact, Riot, etc.

Yes, to cover the contents & improvements inside the leased property.

Yes, adjust the sum insured to reflect improvements.

Either Replacement Value (new-for-old) or Sound/Actual Cash Value (with depreciation).

A contract guaranteeing project completion or regulatory compliance.

• Principal: Business owner
• Obligee: Entity requiring the bond
• Surety: Insurance company

Contractors All Risk – covers civil projects under construction.

Erection All Risk – covers machinery/equipment during installation.

Electronic Equipment Insurance – Covers accidental damage or loss to electronic equipment like computers, servers, and medical devices due to fire, theft, power surges, or breakdowns.

The coverage period is typically annual and is subject to the client’s requirements as well as the insurer’s approval.

Provides coverage for physical loss or damage to construction projects, machinery, equipment, and installations during construction, erection, or testing.

Generally not legally required, but it is strongly recommended or contractually needed to protect businesses from third-party claims for injury or property damage.

Covers third-party bodily injury, property damage, personal injury, and legal defense costs.

Often required in construction projects.

May cause higher future premiums and leave coverage gaps.

Emergency medical, trip cancellation/interruption, and lost belongings.

Depends on the policy; check terms carefully.

Yes, if traveling together, subject to benefit limits.

Limited; check policy restrictions.

Coverage for pre-existing conditions is subject to the terms and conditions of the policy.

Reimburses prepaid expenses for cancellations due to illness, death, gov’t advisory, or weather.

You may contact the assistance or emergency hotline indicated in the policy.