MediCard H.E.R.O. (Health Emergency Response On-demand)

When accidents, emergencies, or sudden health concerns due to infections strike, you need more than just support—you need a hero.

MediCard H.E.R.O. (Health Emergency Response On-demand) is your reliable partner, even if you do not have regular company benefits, MediCard H.E.R.O. covers you from the ER to your hospital bed.

Whether you’re at home, on the road, or in the middle of your daily grind, MediCard H.E.R.O. is the coverage heroes like you, can rely on—for every battle in life, big or small.

• Annual Benefit Limit up to P60,000
• Accepted at 2,000+ hospitals, including 5-star facilities*
• Covers ER treatments for accidents and select infections
• Includes emergency hospital confinement, surgery, and diagnostics
• No deposit required upon admission
• Reimbursement for non-accredited or remote hospitals
• Liaison offcer support for admin needs
• 24/7 digital access via MediCard GO app
• Open to ages 15 days to 65 years old
• No medical screening needed

*5-Star Hospitals:

• Asian Hospital and Medical Center
• Cardinal Santos Medical Center
• Makati Medical Center
• Luke’s Medical Center – Global City
• Luke’s Medical Center – Quezon City
• The Medical City

Rules and limit apply.

Note: Information on this online store is valid until updated.

[Last update: September 9, 2025]

MediCard H.E.R.O. (Health Emergency Response On-demand) covers emergency care cases in all MediCard-accredited hospitals, subject to applicable inner limits, up to the Annual Benefit Limit (ABL) of P60,000, which is the total emergency care limit.

Hospitalization Care Benefits

*MEDICARD RELATIVE VALUE (MRV) is a cost reference used by MediCard in paying professional fees, which are agreed rates duly executed with its accredited providers.

Emergency Care Benefits

**Professional fees will be reimbursed based on the amount MediCard would have paid if the service had been rendered by an accredited physician in an accredited hospital.

Covered Emergency Cases

Trauma Cases

1. Accidental chemical poisoning
2. Animal bites (first dose of anti-rabies)
3. Bone fractures (especially compound or open fractures) from accidents
4. Bowel perforation (due to trauma only)
5. Burns
6. Carbon monoxide poisoning
7. Cardiac tamponade (from trauma)
8. Chemical burns to the eye
9. Choking
10. Drowning or near-drowning
11. Electrocution
12. Falls from height
13. Febrile seizures in infants or toddlers (up to 3 years old)
14. Food poisoning (severe cases with dehydration or shock)
15. Foreign object ingestion (e.g., coins, batteries)
16. Head injuries (e.g., concussion or skull fracture)
17. Poisoning
18. Severe head trauma
19. Severe lacerations or bleeding
20. Smoke inhalation (from fires)
21. Snake or insect bites (e.g., anaphylaxis from bee stings)
22. Sudden airway obstruction (e.g., foreign body aspiration)
23. Sudden infant respiratory distress
24. Sudden vision loss due to trauma
25. Toxic gas exposure (e.g., ammonia, chlorine)
26. Traumatic Bleed
27. Vehicular accidents and other forms of accidents

 Non-Trauma Cases (Conditions caused by bacterial or viral infections):

1. Appendicitis
2. Chikungunya
3. Dengue
4. Leptospirosis
5. Meningitis (especially bacterial)

NOTE: Emergency coverage for non-trauma cases may only be availed starting fifteen (15) calendar days after the membership effectivity date.

Important Guidelines

1. MediCard H.E.R.O. is a multiple-use plan. Members may be covered for more than one emergency case annually, depending on the unused portion of their P60,000 ABL.
2. Each member may purchase only one MediCard H.E.R.O. plan per annual coverage period.
3. The plan does not renew automatically. Members must reapply and purchase a new plan each coverage year.
4. Emergency coverage for non-trauma cases may only be availed starting fifteen (15) calendar days after the membership effectivity date.
5. Emergency cases resulting from trauma are covered immediately starting on the effective date.
6. Emergency Room (ER) must be the first point of care.
7. To view the list of MediCard-accredited hospitals, you may:
   • Visit: https://www.medicardphils.com/accredited-providers/
   • Or register on the MediCard GO app to access the list directly from your mobile device.
8. Pre-existing conditions that result in emergency cases are not covered.
9. Elective or planned confinement is not covered.
10. Only the 32 listed emergency cases are covered subject to other guidelines specified herein. Any condition outside this list is not covered.
11. Coverage is based on final diagnosis, subject to review by the MediCard Operations team in line with emergency care guidelines.
12. Emergency care benefits must be availed within six (6) hours from the time of incident or the onset of symptoms.
13. Coverage excludes emergencies caused by negligence, misconduct, self-inflicted actions, or violations of Philippine law.
14. PhilHealth benefits must be deducted first from the hospital bill. For concerns or queries regarding your PhilHealth benefits and coverage, eligibility, payments, and requirements, please visit https://www.philhealth.gov.ph.
15. Coverage is subject to MediCard’s standard exclusions.

EXCLUSIONS AND LIMITATIONS

1. 1. HOSPITALIZATION
      1. Coverage shall be limited to emergency confinement and shall not extend to elective cases. All confinement shall be upon recommendation of the health program holder’s MediCard accredited Physician, or the MediCard Medical Director or the Emergency Room Resident Physician of the MediCard Accredited Hospital who decides to admit MediCard patient-MEMBER in cases of Emergency Condition and subject to the term Medically Necessary.
      2. Hospital bills for the following hospital services shall be charged to the account of the MediCard patient-MEMBER: services of a private nurse or doctor, use of extra food and/or bed, T.V., electric fan, video/audio disc player, ID bracelet, thermometer and all other items not directly related to the medical management of the patient.
      3. Hospitalization and treatment outside the Philippines are not covered except where there is a coverage for “Emergency Care Services in Foreign Countries,” explicitly indicated in “Schedule A – Benefit Coverage” of the MediCard H.E.R.O. Healthcare Program Agreement (HPA).
      4. MediCard is not responsible and will not recognize any hospital bills incurred by a MEMBER in hospitals not accredited by MediCard, except for emergency care services under the terms provided in the MediCard H.E.R.O. HPA.
      5. Cost of hospitalization, medical services, medicine and other expenses incurred as a result of a MEMBER’s decision to avail of such hospitalization, medical services, treatment or procedure, not prescribed or contrary to what has been prescribed by the MediCard attending physician, not Medically Necessary or outside Eligible Expenses, or without MediCard’s express written report shall not be shouldered by MediCard.
   2. OUT-PATIENT SERVICES
      1. Prescribed Medicines on an out-patient basis are not provided by MediCard-owned Clinics or Medical Service Units.
      2. Second opinions and cost of treatment incurred in non-accredited Hospital or Clinic should the MEMBER unilaterally decide to seek such recourse are not covered.
   3. EXCLUSIONS
      1. Services which a MEMBER receives from a non-MediCard Physician, non-MediCard Accredited Hospital or other provider of care, Accredited Physician in non-MediCard Accredited Hospital or other provider of care, except as described in the emergency care in non-MediCard hospitals, as provided for in the MediCard H.E.R.O. HPA;
      2. Hereditary and/or congenital defects of whatever form;
      3. Sensorineural hearing impairments except those acquired during time of membership;
      4. Plastic and reconstructive surgery for cosmetic purposes and for physical congenital deformities and abnormalities;
      5. Dermatological care for aesthetic purposes such as electrocautery or chemical treatment for skin tags, xanthelasma, milia, keloids, scars, etc. on any exposed areas of the body;
      6. Guillain-Barre syndrome, multiple sclerosis, demyelinating disease, Parkinson’s disease, Alzheimer’s disease, Myasthenia Gravis, epilepsy, seizure disorder and other autoimmune neurological disease;
      7. Slipped disc, scoliosis, spinal stenosis and spondylosis;
      8. AV malformation and aneurysms which are considered congenital except only those unequivocably proven to be acquired secondarily;
      9. Corrective eye surgery for error of refraction including laser surgery for correction of myopia and hypermyopia;
      10. Psoriasis, vitiligo;
      11. Experimental Treatment/Procedure (as defined), acupuncture, acupressure, reflexology and chiropractic therapy;
      12. Services to diagnose and/or reverse infertility or fertility and virility/potency (erectile dysfunction);
      13. Open heart surgeries, angioplasties, valvuloplasties, permanent pacemaker insertion, intracoronary thrombolysis, balloon valvuloplasties, transvenous endocardial biopsy, percutaneous intraaortic balloon pump insertion, balloon atrial septostomy and other surgeries related to the heart; previous craniotomy sequelae; organ transplantation; and all their complications;
      14. Diagnostics for hypersensitivity and desensitization treatment;
      15. Purchase or lease of durable medical equipment, oxygen dispensing equipment and oxygen except during hospital confinement under the Hospital Confinement Benefit;
      16. Corrective appliances and artificial aids and prosthetic devices;
      17. Human blood products like platelets, packed RBC, plasma, gamma globulin, etc. and its processing;
      18. Psychiatric and psychological illnesses including neurotic and psychotic behavior disorders;
      19. Treatment for alcoholic intoxication and drug addiction or overdose reaction to use of prohibited drugs including illnesses directly related to it and other injuries attributed as a result of it;
      20. Rehabilitation treatment, physical, speech, occupational and hormonal therapies;
      21. Developmental disorders, metabolic diseases, sleep and eating disorders;
      22. Sexually transmitted diseases such as Hepatitis B, condyloma, gonorrhea, syphilis, herpes, etc. and their attendant complications;
      23. Pelvic inflammatory disease, tubo-ovarian abscess, pyosalpingitis, etc.;
      24. Human Immunodeficiency Virus (HIV) or Acquired immunodeficiency syndrome (AIDS);
      25. Hazardous job-related illnesses and/or injuries;
      26. Physical examinations required for obtaining or continuing employment, insurance or government licensing, health permit, requirement in school and other similar purposes;
      27. Injuries or illnesses resulting from participation in war-like or combat operations, riots, insurrection, rebellion, strikes and other civil disturbances;
      28. Treatment of Illnesses, self-inflicted Injuries or Injuries attributable to the MEMBER’S
          own misconduct, gross negligence, use of alcohol and/or drugs, vicious or immoral
          habits, participation in act of crime, violation of a law or ordinance, unnecessary
          exposure to imminent danger or hazard to health;
      29. Treatment of injuries or illnesses caused directly or indirectly by engaging in any
          professional sport or hazardous activity such as but not limited to scuba diving, surfing,
          water skiing, mountain climbing, rock climbing, mountaineering, parachuting, airsoft,
          drag racing, paintballing, wakeboarding and bungee jumping;
      30. Maternity care and other conditions as a result of pregnancy unless specifically provided;
      31. Custodial, domiciliary care, convalescent and intermediate care;
      32. Oral surgery for purposes of beautification, temporomandibular joint disease (TMJ)
          surgery done by dental practitioner;
      33. Circumcision, except for correction of Phimosis;
      34. Treatment of injuries sustained in a motor vehicle accident if the MEMBER or his guardian fails or refuses to execute the Deed of Subrogation specified in Article XI, Section 16 of the MediCard H.E.R.O. HPA;
      35. Professional fees of medico-legal officers and fees in securing any form of doctor’s certificate, clearance and the like;
      36. Diagnosis of unknown etiology or the absence of any organic dysfunction;
      37. Cost of vaccines for active and passive immunization except as otherwise provided for in the MediCard H.E.R.O. HPA;
      38. Laboratory examinations for screening sexually related illnesses and injuries;
      39. Infectious Diseases that may arise in times of Epidemic or Pandemic; and
      40. Any condition or illness waived upon membership except as otherwise provided for in the MediCard H.E.R.O. HPA.
   4. LIMITATION IN SERVICES: MediCard is not responsible for the following:
      1. Delay or failure to render services due to major disasters, brownouts or Epidemic or Pandemic affecting facilities or personnel.
      2. Unusual circumstances such as complete or partial destruction of facilities, war, riots, disability of a significant number of MediCard personnel or similar events which result in delay to provide services.
      3. Conditions for which a MEMBER has refused recommended treatment for personal reasons, for which MediCard physicians believe no professionally acceptable alternative treatment exists.
      4. Sudden change of hospital policies.
      5. Any act, omission, negligence or malpractice of Accredited Hospitals, Clinics and Physicians/Doctors, being independent contractors, in connection with medical services rendered.
      6. Any services or benefits not expressly stated under Schedule A – Benefit Coverage, regardless of whether such terms appear in the general clauses or Definition of Terms.
   5. EXTRAORDINARY EVENT OR FORCE MAJEURE
      1. MediCard shall not be held liable for any delay, interruption, or failure to perform its obligations under the MediCard H.E.R.O. HPA where such delay or failure is due to any Extraordinary Event or Force Majeure.
      2. In such events, MediCard reserves the sole right, at its discretion, to implement temporary or continuing adjustments to service delivery mechanisms, provider networks, clinical protocols, benefit structures, or utilization controls, as may be required to comply with regulatory directives or to ensure continued operation of the healthcare program. MediCard shall provide written notice to the MEMBER prior to or as soon as practicable following the implementation of such changes.
      3. If the Extraordinary Event of Force Majeure results in a sustained or material increase in claims utilization, cost of services, or operational disruptions, MediCard shall have the right to initiate a review and adjustment of premium rates or benefits.
      4. Such adjustments shall be based on MediCard’s internal actuarial assessment and shall take effect upon written notice to the MEMBER.

In consideration for the services rendered by MediCard, the Client agrees to pay the one (1) year membership fee of Six Thousand Pesos (P 6,000.00) inclusive of 12% VAT upon enrolment with MediCard. Membership fee shall be valid within the one (1) year membership period only.

Make sure that you have secured a copy of the Memorandum of Agreement (MOA) for your reference. You can download and/or print a copy of the MOA by clicking the button below.

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