Maxicare LifesavER Plus

Title: Maxicare LifesavER+

Emergency Room coverage plus confinement with access to the 6 major hospitals

Description:

Highlights

• Benefit of up to ₱50,000 coverage on Emergency Room treatment, including those requiring confinement in a regular private room

• Single usage per card. You can use multiple cards in a year

• Eligible for ages 15 days old to 65 years old only

• Group Life with Accidental Death, Dismemberment & Disablement (ADD&D) up to ₱50,000

• Emergency medical assistance with Assist America for members who are traveling more than 150km from home, or in a foreign country, for up to 90 days*

• Valid for 1 year from activation date

• Covers preexisting conditions

• No preliminary checkups and paperwork needed

• Nationwide access to Maxicare-affiliated hospital providers, including the 6 major hospitals

• 15 days Activation Period

* This is in partnership with Assist America. Visit their website www.assistamerica.com for more information.

Coverage

Coverage for life-threatening conditions, illnesses, and/or injuries, as well as unexpected onset of conditions or illnesses that require immediate medical assistance or alleviation of pain or discomfort within 24 hours. This includes, but is not limited to, fractures from accidents, severe burns, allergic reactions, and asthma attacks. Coverage includes confinement in a regular private room when medically necessary coming from an emergency.

Includes

• Outpatient emergency coverage

• Doctor’s services for emergency treatment

• Emergency room fees

• Emergency medicines for immediate relief and treatment (no take-home medication)

• Oxygen, IV fluids, whole blood, and human blood products

• Dressings, casts, sutures

• X-ray, laboratory, and diagnostic exams

• Initial treatment of animal bites for the first 24 hours

• Initial vaccination for tetanus and animal bites

Inpatient coverage

• Room and board accommodation in a regular private room

• Use of Operating Room, Intensive Care Unit (ICU), Isolation Room (if prescribed by the affiliated attending physician), and Recovery Room

• Professional fees

• Standard nursing services

• Medicines when in confinement

• Whole blood products and IV fluids transmission

• X-ray, laboratory, and diagnostic exams

• Anesthesia, oxygen, and their administration

Additional benefits to Maxicare LifesavER+ members only

• Access up to 12 Maxicare 24/7 Teleconsult Voice Call at (02) 8582-1980

• Travel emergency medical assistance if within 150km from place of residence

Exclusions and Limitations

1. Non-Emergency Services

• Services obtained for non-emergency conditions from Physicians and Providers

2. Hospital and Medical Care Limitations

• Additional charges for room upgrades and extended stays

• Non-medical furnishings, appliances, personal items, extra food, and toiletries

• Private or special nurse services

• Custodial, domiciliary, convalescent, and intermediate care

• Long-term rehabilitation

3. Mental Health and Developmental Disorders

• Psychiatric care and long-term rehabilitation

• Developmental disorders (e.g., ADD/ADHD, Autism, Bipolar Disorders)

4. Self-Inflicted Injuries and Risky Behaviors

• Injuries from tattoos, body piercing, attempted suicide

• Injuries resulting from negligence, drug/alcohol use, crime, law violations

• Injuries from professional sports or hazardous activities

• Injuries from riots, strikes, civil disturbances, or war

5. Cosmetic and Elective Procedures

• Aesthetic, cosmetic, and reconstructive surgery

• Weight reduction programs and related procedures

• Circumcision (except for urological conditions)

6. Dental and Oral Health

• Dental treatments and oral surgery (except for accidental injury)

7. Reproductive Health

• Maternity care and pregnancy-related conditions

• Fertility/infertility treatments, sterilization, sex transformation

8. Experimental and Alternative Treatments

• Experimental medical procedures

• Alternative medicine (e.g., acupuncture, chirotherapy)

9. Organ Donation

• Expenses for the member as an organ donor

10. Routine and Preventive Care

• Routine physical examinations for employment, school, insurance, travel, etc.

• Vaccines and immunizations (including administration)

11. Medical Equipment and Supplies

• Purchase or lease of durable medical equipment (except during covered in-patient care)

• Corrective appliances, prosthetics, and orthotics

• Take-home and out-patient medicines (with some exceptions)

12. Genetic and Chronic Conditions

• Congenital, genetic, and hereditary diseases (except for hernias)

• Chronic Dermatoses

• Chronic illnesses and related conditions

• Diabetes mellitus, Hypertension, Lipidemia, and related illnesses

• Neoplasm and related illnesses

• Gallbladder stones and related illnesses such as but not limited to Cholelithiasis and Cholecystitis

13. Infectious Diseases

• Sexually transmitted diseases, HIV, and AIDS

• Infectious diseases declared as epidemics or pandemics

• Hepatitis B and related screenings/vaccines

14. Specific Treatments and Procedures

• Speech therapy for developmental and congenital diseases

• Intravenous Immunoglobulin (IVIG)

• Scoliosis treatments (except during emergency care)

15. Financial Limitations

• Costs exceeding the Annual Benefit Limit (ABL)

• Medico-legal case costs
  

Provider Access

Nationwide access to Maxicare-affiliated hospital providers, including the 6 major hospitals:

• Asian Hospital and Medical Center

• Cardinal Santos Medical Center

• Makati Medical Center

• St. Luke’s Medical Center - Bonifacio Global City

• St. Luke’s Medical Center - Quezon City

• The Medical City

How to Activate Your Maxicare LifesavER+

After purchasing from the online shop, you need to activate your e-voucher with a reference number before you can use it (e.g. 2091147124643).

*The membership registration period is up to three (3) months from the date of purchase

Via ONLINE

1. Visit the Online Card Registration Page: memberviewpoint.maxicare.com.ph

2. Enter the reference number that you’ll receive by email after purchase

3. Provide the required personal details and click “Submit”

4. Once successfully registered, you will receive an an email together with your Maxicare LifesavER+ electronic card (eCard) within 24 hours

5. Your membership will be activated 15 days after successful registration.

Reminders

• The card is non-transferable once registered

• Membership is valid up to 1 year from the date of activation

• Present your Maxicare LifesavER+ card or eCard along with 1 valid ID (e.g. Passport, SSS, TIN, Driver’s License, etc.)  with a photo when availing the services offered in this healthcare plan

• No card or eCard, no valid ID, no availment

• See the FAQ for a list of valid IDs

• Subject to a 15-day free-look period. You may only refund the product if you haven’t used the card.

• The card will be considered used and will automatically be canceled once you swipe the physical card or enter the card number for eCard in the POS Terminal in the Emergency Room. Any excess will be covered by the member, and the balance amount is not convertible to cash.

• Members can only avail from one Maxicare-affiliated hospital within 24 hours.

• You can use more than one card in a year, but only one can be active at a time

• Members can register another card under the following conditions:

• (1) If with any availment - 15 days after the availment 

• (2) If without any availment - 1 day after the expiration 

***Note that for all conditions, the card will be activated 15 days after successful registration.