Health Vantage

Health Vantage program also covers outpatient emergency care and emergency care leading to hospitalization up to the plan benefit limit. There are 3 variants of Health Vantage card: Health Vantage 40, Health Vantage 60, and Health Vantage 80. Depending on the age of the enrollee.

It is so convenient to have a Health Vantage card. Individuals 6 months to 64 years old may be enrolled under these programs. However, the entry age is up to 64 years old only.

Depending on the program’s service coverage, the following are the covered conditions:

· Accidents, excluding Cerebrovascular (Stroke)

· Acute Appendicitis

· Acute Bronchitis

· Acute Gastroenteritis

· Acute Pharyngitis

· Acute Sinusitis

· Acute Tonsillitis

· Acute Upper Respiratory Tract Infection

· Cellulitis

· Dengue

· Fracture, new

· Acute Pneumonia

· Sprain

· Typhoid Fever

· Upper Respiratory Tract Infection

· Urinary Tract Infection

· Viral Infection

Accidents except for cerebrovascular accidents (stroke) and injuries suffered because of member’s misconduct, voluntary participation in hazardous sport or activity and military service or under conditions of war.

Non-emergency, pre-existing, congenital, maternity related and those conditions under PhilCare’s general exclusion list will not be covered.

An illness or condition is considered pre-existing if prior to the effective date of health coverage the pathogenesis of such illness or condition has started, whether the member is aware or not.

Emergency cases are the sudden, unexpected onset of illness or injury, which at the time of contract reasonably appeared as having the potential of causing immediate disability or death or requiring the immediate alleviation of severe pain and discomfort. Emergency cases include but are not limited to the following:

(a) Massive Bleeding;

(b) Acute Appendicitis;

(c) Fractures/multiple injuries secondary to accidents;

(d) Convulsions;

(e) Illnesses or conditions resulting in moderate or severe dehydration such as diarrhea or fever; and

(f) Syncope.

Health Vantage vouchers/cards, depending on the chosen variant, provides coverage of hospital emergency room care plus expenses for the room and board, diagnostic and therapeutic procedures as medically necessary during confinement up to the plan aggregate limit. Special modalities of treatment is also subject to ₱ 5,000 inner limit.