DESCRIPTION:

Unli-Consult for Adults: This health plan allows you to avail unlimited consultation services for one (1) year from PhilCare-accredited network of medical specialists and dentists nationwide.

ER Vantage 40 for Adult: A single-use healthcare plan that provides coverage of up to P40,000 for emergency care and hospitalization for viral and bacterial illnesses, treatment of injuries resulting from accidents (except for stroke) in 500+ designated PhilCare-accredited hospitals nationwide. 

Age Eligibility and Validity 

Unli-Consult for Adults is for age 18 to 65 years old and is valid for 1 year upon activation date. Benefits starts 3 days after activation date. This Certificate of Coverage is non-transferable once activated.

ER Vantage Plus 40 for Adults is for age 18 to 65 years old and is valid for 1 year upon activation date. Benefits starts 7 days after activation date. The Certificate of Coverage is non-transferable once activated.

Benefit Coverage 

Unli-Consult for Adults * this health plan allows you to avail unlimited consultation services for one (1) year from PhilCare-accredited Family Medicine, Internal Medicine, General Physician, Cardiologists, Nephrologists, Pulmonologists, Gastroentrologists nationwide and dentists nationwide and one (1) year unlimited HeyPhil Digimed consultations. ** The Coverage is inclusive of the following benefits:

Dental Service:

• Annual dental examination/annual oral examination
• Unlimited orthodontic or aesthetic consultation
• Gum treatment for lesions, wounds, and burns, except alveolectomy and gingivectomy
• Relief and/or prescription for acute dental pain
• Diagnosis of oral disease, restorative and prosthodonctic treatment planning
• Dental nutrition and dietary counseling
• Dental health education through Chairside Instruction
• First aid treatment/emergency treatment
• Unlimited temporary fillings
• Re-cementation of loose crowns, inlays, onlays, and fixed bridges
• Simple repair and adjustment of denture
• Simple tooth extraction/unlimited simple extraction of an unsavable tooth
• Desensitization of hypersensitivity teeth
• Annual prophylaxis (light cases only)

Exclusions:

Pre-existing conditions are covered. The only exceptions are maternity-related cases and cases related to all forms of behavioural disorders, developmental or psychiatric disorder and psychosomatic illness whether acquired or congenital. **

Outpatient Emergency Care and Hospitalization Care Benefits:

ER Vantage Plus 40 for Adults * gives you a one-time coverage up to Php 40,000 for viral, bacterial illnesses and treatment of injuries resulting from accidents (except stroke) ** In more than 500 accredited hospitals nationwide excluding nine (9) premium hospitals (Makati Medical Center, St. Luke’s Medical Center in QC and Global, Asian Hospital, The Medical City, Cardinal Santos Medical Center, Manila Adventist Medical Center, Notre Dame de Charles Hospital and Philippine Orthopedic Institute). The Coverage is inclusive of the following benefits:

• Room and board (Ward Room)
• Doctors’ fees
• Laboratory and diagnostics procedures
• Special modalities of treatment as medically necessary during ER and confinement, subject to P5,000 inner limits
• Medicines (except vaccines) as medically necessary during ER and confinement except for cases declared as non-coverable ** , subject to standard inner limits
• Diagnostic and therapeutic procedures as medically necessary during ER and confinement

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: (a) Massive Bleeding; (b) Acute Appendicitis; (c) Fractures/multiple injuries secondary to accidents; (d) Convulsions; (f) illnesses or conditions resulting in moderate or severe dehydration such as diarrhea or fever; and (h) Syncope. Pre-existing conditions and those conditions under the general exclusions of PhilCare are not covered. **
 

Other Additional Benefits (this benefit is provided by a third party-insurance provider) :

• Php 50,000 accidental death and disability coverage