Outpatient Plus
We believe that everyone deserves access to affordable quality healthcare. With MediCard Outpatient Plus, you have access to unlimited consultations with hand picked doctors.
From routine check-ups to annual physical exam, dental and emergency benefits, we’re committed to supporting your overall well-being while addressing your unique healthcare needs.
[Last update: January 10, 2024]
BENEFITS
OUT-PATIENT 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)
- Dermatologist
- 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)
- Dermatologist
- Ophthalmologist
- ENT
NOTE: Free consultations may be availed of starting 7 days after date of effectivity
EMERGENCY CARE BENEFIT
In our MediCard Free-Standing Clinics and 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 30k
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 (A.P.E.) 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
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 BENEFIT
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 C/O MEDICARD
- 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.
EXCLUSIONS
NO IN-PATIENT SERVICES
- Issuance of medical certificate shall not be covered during out-patient consultation
- Take home medicines and medical supplies shall not be covered
- Prescribed medicines shall not be provided by MediCard or MediCard-accredited doctors/hospitals/clinics
- Hospitalization and treatment outside the Philippines are not covered
- Cost of medical services, medicine and other expenses incurred as a result of a MEMBER’s decision to avail of such medical services, treatment or procedure, not prescribed or contrary to what has been prescribed by the attending MediCard provider, or without MediCard’s express written report shall not be covered by MediCard
- Bandages, fiberglass and other forms of prosthetics, medical appliances, pins, screws and the like
- Plastic and reconstructive surgery for cosmetic purposes and for physical congenital deformities and abnormalities
- Slipped disc, herniated disc, scoliosis, spinal stenosis and spondylosis
- Experimental medical procedures, acupuncture, acupressure, reflexology and chiropractics
- Purchase or lease of durable medical equipment, oxygen dispensing equipment and other medical supplies
- Corrective appliances, artificial aids and prosthetic devices
- Human blood products like platelets, packed RBC, plasma, gamma globulin, etc. and its processing
- Psychiatric and psychological illnesses including neurotic and psychotic behavior disorders
- 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
- Rehabilitation treatment and physical therapies
- Hazardous job-related illnesses and/or injuries
- Injuries or illnesses resulting from participation in war-like or combat operations, riots, insurrection, rebellion, strikes, domestic violence and other civil disturbances
- Treatment of 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, combat sports and sparring such as tae kwon do, boxing, muay thai, sports injuries without the use of proper equipment and hazardous sports related injuries
- Oral surgery or (TMJ) surgery done by dental practitioner
- Treatment of injuries sustained in a motor vehicle accident if the MEMBER or his guardian fails or refuses to execute the deed of Subrogation
- Professional fees of medico-legal officers
- Cost of vaccines for active and passive immunization other than tetanus toxoid, anti-tetanus serum, and active immunization for rabies
- Follow-ups at the emergency room
- All other forms of services not mentioned under this Agreement
LIMITATION IN SERVICES:
MediCard shall not be responsible for the following:
- Delay or failure to render services due to major disasters and natural calamities, brownouts or epidemics affecting facilities or personnel
- 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
- Conditions for which a MEMBER has refused recommended treatment for personal reasons, for which MediCard physicians believe no professionally acceptable alternative treatment exists
- Sudden change of hospital policies
- Failure of the patient to get the proper treatment if deemed not covered by MediCard
- Out-patient consultations outside clinic hours
OTHERS:
- The member shall not use the benefit of his other MediCard card/s on top of the limitations of the MediCard Outpatient Plus package or vice versa.
- In cases wherein the member has multiple MediCard Outpatient Plus cards, the member shall only use his MediCard Outpatient Plus card one at a time.
PRICE LIST
In consideration for the services rendered by MediCard, the Client agrees to pay the one (1) year membership fee of Six Thousand Nine Hundred Ninety Pesos (P 6,990.00) inclusive of 12% VAT upon enrolment with MediCard. Membership fee shall be valid within the one (1) year membership period only.
MOA / TERMS AND CONDITIONS
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.
We believe that everyone deserves access to affordable quality healthcare. With MediCard Outpatient Plus, you have access to unlimited consultations with hand picked doctors.
From routine check-ups to annual physical exam, dental and emergency benefits, we’re committed to supporting your overall well-being while addressing your unique healthcare needs.
[Last update: January 10, 2024]
BENEFITS
OUT-PATIENT 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)
- Dermatologist
- 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)
- Dermatologist
- Ophthalmologist
- ENT
NOTE: Free consultations may be availed of starting 7 days after date of effectivity
EMERGENCY CARE BENEFIT
In our MediCard Free-Standing Clinics and 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 30k
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 (A.P.E.) 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
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 BENEFIT
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 C/O MEDICARD
- 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.
EXCLUSIONS
NO IN-PATIENT SERVICES
- Issuance of medical certificate shall not be covered during out-patient consultation
- Take home medicines and medical supplies shall not be covered
- Prescribed medicines shall not be provided by MediCard or MediCard-accredited doctors/hospitals/clinics
- Hospitalization and treatment outside the Philippines are not covered
- Cost of medical services, medicine and other expenses incurred as a result of a MEMBER’s decision to avail of such medical services, treatment or procedure, not prescribed or contrary to what has been prescribed by the attending MediCard provider, or without MediCard’s express written report shall not be covered by MediCard
- Bandages, fiberglass and other forms of prosthetics, medical appliances, pins, screws and the like
- Plastic and reconstructive surgery for cosmetic purposes and for physical congenital deformities and abnormalities
- Slipped disc, herniated disc, scoliosis, spinal stenosis and spondylosis
- Experimental medical procedures, acupuncture, acupressure, reflexology and chiropractics
- Purchase or lease of durable medical equipment, oxygen dispensing equipment and other medical supplies
- Corrective appliances, artificial aids and prosthetic devices
- Human blood products like platelets, packed RBC, plasma, gamma globulin, etc. and its processing
- Psychiatric and psychological illnesses including neurotic and psychotic behavior disorders
- 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
- Rehabilitation treatment and physical therapies
- Hazardous job-related illnesses and/or injuries
- Injuries or illnesses resulting from participation in war-like or combat operations, riots, insurrection, rebellion, strikes, domestic violence and other civil disturbances
- Treatment of 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, combat sports and sparring such as tae kwon do, boxing, muay thai, sports injuries without the use of proper equipment and hazardous sports related injuries
- Oral surgery or (TMJ) surgery done by dental practitioner
- Treatment of injuries sustained in a motor vehicle accident if the MEMBER or his guardian fails or refuses to execute the deed of Subrogation
- Professional fees of medico-legal officers
- Cost of vaccines for active and passive immunization other than tetanus toxoid, anti-tetanus serum, and active immunization for rabies
- Follow-ups at the emergency room
- All other forms of services not mentioned under this Agreement
LIMITATION IN SERVICES:
MediCard shall not be responsible for the following:
- Delay or failure to render services due to major disasters and natural calamities, brownouts or epidemics affecting facilities or personnel
- 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
- Conditions for which a MEMBER has refused recommended treatment for personal reasons, for which MediCard physicians believe no professionally acceptable alternative treatment exists
- Sudden change of hospital policies
- Failure of the patient to get the proper treatment if deemed not covered by MediCard
- Out-patient consultations outside clinic hours
OTHERS:
- The member shall not use the benefit of his other MediCard card/s on top of the limitations of the MediCard Outpatient Plus package or vice versa.
- In cases wherein the member has multiple MediCard Outpatient Plus cards, the member shall only use his MediCard Outpatient Plus card one at a time.
PRICE LIST
In consideration for the services rendered by MediCard, the Client agrees to pay the one (1) year membership fee of Six Thousand Nine Hundred Ninety Pesos (P 6,990.00) inclusive of 12% VAT upon enrolment with MediCard. Membership fee shall be valid within the one (1) year membership period only.
MOA / TERMS AND CONDITIONS
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.
