09/06/2024
😍 MyMaxicare 💙 Health Plan
Individual / Family Plans
One (1) Year - Renewable
Age Eligibility: 15 days old to 60 years and 5 months old
Maximum Benefit Limits (MBL)
Platinum Plus - P250,000
Platinum - P200,000
Gold - P150,000
Silver - P100,000
(*per member, per illness, per year)
✅In-Patient Benefits
✅Emergency Care
✅Preventive Care
✅Annual Check-up (ACU)
✅Dental Care (Optional - additional as rider)
✅Life Insurance coverage of 50K including ADD&D
✅Value Added Features :- Assist America
✅Dreaded Disease / Conditions accepted
✅Out Patient Services/Non-Emergency Services
✅Easy Enrollment Process
✅Heirarchy on enrollment is applied
✅Modes of Payment :- Semi-Annual and Annual
✅Pre-existing illnesses are considered with limitations
For Dreaded Conditions (*per member, per illness, per year)
Platinum Plus - P20,000
Platinum - P15,000
Gold - P10,000
Silver - P5,000
Non-Dreaded Conditions - coverage up to MBL
Premium rates depends on age upon enrollment - please see table of rates.
Application - subject for approval
Payment upon approval of application
Upon approval, statement of account (SOA) will be received via official email addressed declared on application form - for payment
Personalized physical card will be provided (30 days subsequent to approval)
Online access on Maxicares Member's Gateway
REQUIREMENT:
(to be sent to email, FB Messenger or Viber)
1. Completely filled out Application Form
2. One (1) Valid Government ID (clear picture)
3. Applicable Birth Certificate/s, Marriage Certificate, Alien Certificate
*** Additional requirement/s may be requested as needed
Please fill out the following details (for registration):
Salutation: Mr/Ms/Mrs/Other
First Name:
Middle Name:
Last Name:
Extension(Jr,Sr,I,II,III):
Gender: (M/F)
Date of Birth:
Place of Birth:
Age:
Civil Status:
Gender:
Height:
Weight:
Current BP rate:
No. of Children: (NA if not aplicable)
Business Name:
Occupation/Designation:
Source of Funds: (salary/business,savings,investment,etc)
Contactable Mobile No.:
Valid & accessible email address:
Complete Present Address:
Complete Billing Address:
Mode of Payment: (annual/semi annual)
Type of Payment: (credit/debit card, online payment, bank transfer)
Dental Services?: (yes/no) (387/annual; 209/semi annual) (optional)
Have you been diagnosed with any medical condition? (yes/no)
Are you taking any maintenance medicines? (Y/N)
If Yes, please specify:-
✅PhilHealth No.:
✅Valid/Government ID Presented: