Benefits and Availments
To know more, please choose from the list below
Watch the video above for an overview of Availment Procedures
- Administration of immunization (excluding cost of vaccines)
- Family planning and counseling
- On-going records of medical history
- Medical Management of health problems, health education, counseling on diet and exercise
- Wellness programs/ lecture/seminars based on topic of choice
- Annual Physical Examination (APE)
- Medical History
- Physician's Assessment
- Chest X-ray
- Fecalysis (stool exam)
- Urinalysis (urine exam)
- Complete Blood Count
- ECG for 35 y. o. & above
- Pap smear for female 35 y. o. & above
- Consultations & treatments with plan coordinators
- Referrals to accredited specialists
- Dressings, sutures, & casts (except fiberglass supplies)
- Treatment of minor injuries (i.e. laceration, minor burns, sprain, etc.)
- Minor surgical procedures not requiring confinement
- Pre/post-natal consultation with accredited OB-gynecologists
- NOTE: Procedures more than P1,000 are for approval.
AVAILMENTS PROCEDURES
- Room and board based on member's plan
- Professional fees of the attending physicians, surgeons & anesthesiologist
- Standard nursing services
- Use of the operating room/recovery room, ICU/CCU
- Oxygen and inhalation therapy
- Blood transfusions, including human blood products except gamma globulins
- BDressings, casts and sutures (except fiberglass supplies)
- All drugs, medicines and injectables while confined including IV fluids, anesthesia & its administration
- Prescribed X-rays, laboratory exams & diagnostic procedures
- Admission kit
- Step 1 Proceed to Admitting Section of ValuCare (VC) accredited hospital
- Step 2 Present your admitting order and your VC card
- Step 3 VC will issue the LOA after proper verification
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Step 4
Upon discharge:
- File PhilHealth (Medicare)
- Check Hospital charge slips
-Settle charges not covered by ValuCare, if any
AVAILMENTS PROCEDURES
- Doctors & hospital services
- Medications used for immediate relief of symptoms
- Standard nursing services
- Dressings and sutures for wound; casts (except fiberglass supplies)
- Prescribed X-rays, laboratory exams & diagnostic procedures
- Other medical services related to the emergency management which are deemed necessary to the treatment of the case.
- Emergency care in areas without accredited hospitals reimbursable up to
- Maximum Coverage Benefit (MCB) based on VC Relative Units globulins
- Non-accredited hospitals
- Foreign territories while on official business trip
-
-reimbursable up to P30,000
-80% of applicable hospital bills
-100% of PF based on ValuCare Relative Values
- Step 1 Proceed to Emergency Room (ER) of ValuCare (VC) accredited hospital & present VC card
- Step 2 ER personnel will render proper treatment
- Step 3.1 For admissions: Follow In-Patient procedures
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Step 3.2
For non-admissions, upon discharge from ER:
- Sign necessary documents
- Check Hospital charge slips
-Settle charges not covered by ValuCare, if any
AVAILMENTS PROCEDURES
- Doctors & hospital services
- Emergency cases at medical facilities not accredited by ValuCare may be reimbursed up to P30,000
- Emergency cases on official business trip outside Philippine territory may be reimbursed up to P 30,000
- Reimbursements will be based on the schedule below:
- 80% on Room & Board, based on the member's plan
- 80% on medicines, laboratory/diagnostic procedures
- 100% of the physicians fee, based on ValuCare rates
PERSONALIZED ACCESS TO LABORATORY SERVICES
Blood tests requiring fasting done at HOME or at the OFFICE at no extra cost.
*NOTE: PALS is initially available in Metro Manila area only.