This is a comprehensive medical insurance that covers inpatient, outpatient, and emergency services. Doctor prescribed tests and consultations are also included up to the maximum benefit limit. It offers no-cash-out in accredited clinics & hospital nationwide.
PhilHealthCare, Inc.
Provider
Up to ₱ 150,000
Inpatient, Outpatient, and Emergency Services
Coverage is available for the Principal, Spouse, and Parents aged 18 to 60, with renewals allowed up to 65. Children and Siblings are covered from 30 days to 22 years old.
Eligible age
Coverages
Medical Insurance
Maximum Benefit Limit
₱ 150,000
Room and Board
Regular Private
Access to all accredited hospitals and clinics including top 6
Included
Pre-existing conditions (covered after 6 months)
Covered up to 50% of Maximum Benefit Limit
Outpatient Benefits
Covered up to Maximum Benefit Limit
Inpatient Benefits
Covered up to Maximum Benefit Limit
Doctor Prescribed Laboratory and Diagnostic Tests
Covered up to Maximum Benefit Limit
Doctor Consultations and Teleconsultations
Covered up to Maximum Benefit Limit
KwikRewards Program Membership
Included
Important Notes
About the Product
This Product is underwritten by PhilHealthCare, Inc.
Excluded Coverages
Excluded Industries/Nature of Business
a. Government Associations, Government Agencies, Government Financial Institutions, Government and Government Owned and Controlled Corporations, and company related to Government.
b. Health Services (including veterinary clinics, dental clinics, and schools related to hospitals).
c. Non-legally established groups, groups formed for the purposes of acquiring insurance and open groups.
d. Hazardous occupations are not covered such as, but not limited to blasters, stuntmen, pilot, armed forces, police, odd job laborers, mining, etc.
e. Agricultural sectors
f. Unemployed; except dependents
g. Employees of associations, cooperatives, non-profit organizations will be allowed if provided proof or certification from the authorized signatory that coverage is an employee
Want to Know More?
To learn more about the product, read the Policy Wording.
To learn more about KwikRewards program, read the Terms & Conditions
Frequently Asked Questions
When will the service be activated?
The service will be activated 15 days after the inception date, which is one day from the date of purchase.
Are all pre-existing conditions covered?
All new purchase from January 21, 2025, pre-existing conditions will be covered after six (6) months of continuous subscription, up to 50% of the MBL.
For renewing members, PEC is covered up to MBL from 2nd year onwards.
What incidents are considered emergency accident-related cases?
Emergency accidental cases that will be covered during the fifteen (15) days waiting period are injuries sustained from vehicular accidents (with police report), acts of nature, struck by falling objects, drowning, and burns.
What happens if the client will not be able to pay on time?
The health subscription plan will be automatically cancelled if client will not be able to pay on time.
Can subscription be reactivated?
Within 60 Days: Reinstatement is allowed, provided any arrears are settled promptly. Subscription will undergo an activation period of seven (7) days before the subscriber can use its services such as consultations, laboratory, and diagnostic tests, etc.
After 60 Days: Reinstatement is no longer permitted; a new policy must be purchased, and the PEC waiting period and coverages will be reset.
Do employees have to enroll on their own or through HR Admin?
For group administered enrolments, the HR Admin must be the one to enroll their employees.
For individual enrolment, employees can enroll on their own in the portal.
Who pays for the subscription?
For group administered employees, billing will be sent to the company, thus it is the company who will pay for the subscription.
For individual enrolment, the employee or individual is the one who will pay for the subscription.
Where can I pay my premium?
All payments should be processed exclusively through our official online channel to ensure security and accuracy. If anyone from our affiliates or advisors requests that payments be sent directly to them, please contact us immediately so we can ensure everything is properly accounted for.
Can I enroll my dependents here?
Yes, employees or individuals who wish to enroll their dependents can do so.
Dependent may be enrolled with the type of plan that is same or lower plan than his principal’s plan.
Dependents must be enrolled simultaneously or within thirty (30) days from enrollment of the Principal Member except for cases involving marriage or the birth of a child wherein enrollment must be made within thirty (30) days from their eligibility date (i.e. child may be enrolled from 30-60 days old).
When the principal member's coverage ends, the dependent's coverage also ends.
I am an existing member. How can I add a dependent?
Dependents must be enrolled simultaneously or within thirty (30) days from enrollment of the Principal Member except for cases involving marriage or the birth of a child wherein enrollment must be made within thirty (30) days from their eligibility date (i.e. child may be enrolled from 30-60 days old).
You may wait for your annual renewal, to add new dependents.
Is PhilHealth necessary? What if I don't have PhilHealth?
Yes, Philhealth is necessary. For those enrollees who do not have Philhealth, you can still continue with the enrollment and may opt to do the following:
Do clients need to bring money to the hospital?
No, since this is a cashless transaction, clients don’t need to bring money to the hospital (affiliated hospitals and clinics) when using the services.
Do clients need to bring their card?
Since this is an app-based health subscription plan, clients don’t need to bring cards in the hospital. All they need to do is present their e-card issued to them that can be found in their mobile app.
What do clients need to do to schedule a check-up?
For check-ups, clients can use their app to set a schedule with the doctor and generate LOA.
What are Pre-existing conditions?
Pre-existing conditions are any illnesses, injuries, or conditions that are pre-existing any time prior to the effective date of the member’s coverage which will start after six months of continuous subscription.
How to determine if you have pre-existing conditions?
- If member had professional advice or treatment for a certain condition;
- If there are symptoms that are evident in any way to the member;
- If any of the conditions below is diagnosed before or within the first six months of subscription:
asthma, pleural effusion, or other chronic airway obstruction conditions;
benign cyst/tumor and malignant conditions;
chronic gynecologic conditions;
hemorrhoids and other chronic colonic and ano-rectal illnesses;
disease tonsils requiring surgery, cataracts and other ophthalmo-otolaryngologic conditions;
pathological abnormalities of nasal septum and turbinate;
sinus condition requiring surgery;
chronic neurologic conditions;
calculus cholecystitis/cholelithiasis and/or urolithiasis;
chronic conditions of the genitourinary system;
polyps, ulcers, liver cirrhosis and other chronic gastrointestinal diseases;
endocrine illnesses;
seizure disorders;
moderately to far advanced tuberculosis;
chronic musculo-skeletal malignancies
malignancies of the blood and bone marrow
hypertension, coronary artery disease/myocardial ischemia, cerebro-vascular accident and other chronic cardiac diseases
collagen/connective tissue diseases;
diseases of the immune system.
If I pay in advance, will I be qualified to be covered of the pre-existing condition coverage even if it’s less than six (6) months?
No, even if a client opts to pay in advance, they will not be qualified to be covered by the pre-existing coverage if they haven’t been subscribed to the program for six (6) consecutive months of subscription.
What events are considered emergency for pre-existing conditions coverage?
Life-threatening cases such as but not limited to heart attack, stroke, severe asthma attack, sudden paralysis, elevation in blood pressure, and seizure disorders only. Coverage for emergency cases is for expenses within the emergency room and is limited to doctor fees, treatment, and medicine. Surgical operations and room & board related to pre-existing conditions are excluded even if they are brought about by emergencies.
Can I pay for an annual subscription?
Clients who wish to pay for an annual subscription can do so by contacting our customer service support for the payment link.
What are your accredited hospitals?
This is the link of accredited hospitals nationwide:
https://shop.philcare.com.ph/accredited-hospitals
https://www.philcare.com.ph/philcare-clinics
https://shop.philcare.com.ph/clinic-locations
Are your plans accredited in all major hospitals?
Yes, our plans are accredited in all major hospitals including Makati Medical Center, St. Luke’s Global City & Quezon City, Asian Hospital Medical Center, The Medical City, etc.
What is the age eligibility for this product?
This plan accepts initial enrollment only up to the age of 60 years old. Renewal accounts are eligible for coverage for individuals aged 61 to 65 years old.
Coverage automatically ends on the day before the employee celebrates his 66th birthday or retires from employment, whichever is earlier.
Coverage for minors (0-17 years old) will only be enrolled as an immediate dependent of an employee. Minor dependents must be fully dependent on the employee, unmarried, and unemployed.
KwikRewards FAQs
What is the KwikRewards Program?
KwikRewards is a loyalty program that provides KwikCare Subscribers the opportunity to earn KwikRewards Tokens by helping promote a healthy lifestyle and our products and services.
Who are eligible to join the program?
Only KwikCare Subscribers are eligible to join the KwikRewards program as the monthly membership is part of the inclusions in a KwikCare Subscription.
How do I register to the program?
You will receive a welcome email 8 days after your purchase. This is after the free-look period of KwikCare Subscription.
Can my dependents register in the program?
Only principal subscribers will be registered in the program. However, the dependents will also automatically earn KwikRewards Tokens should principal members accomplish token-earning activities. The tokens will be emailed to the principal.
How much is KwikRewards monthly membership?
It is free to KwikCare Subscribers. It is part of the KwikCare Subscription inclusions.
What are KwikReward Tokens?
KwikRewards Tokens are used to redeem reward credits in the KwikRewards Portal. Each token has a value of P500 credits. They are stackable (can be accumulated) and can be used to claim different reward amounts.
What is the KwikRewards Portal?
It is the website where KwikRewards Tokens can be redeemed and exchanged for Credits to be used in the website. Members can choose from different categories:
How are KwikRewards Tokens earned?
KwikRewards Tokens are earned by participating in activities that promote a healthy lifestyle and our products each month. We will email qualified members each month about token-earning opportunities.
When are KwikRewards Tokens disbursed?
Tokens are disbursed based on the accomplishment of tasks and its submission dates of accomplished token-earning activities:
Accomplishment and Submission | Token Release |
---|---|
On or before 7th | 13th of same month |
On or before 14th | 20th of same month |
On or before 21st | 27th of same month |
On or before 28th | 6th of following month |
What do I do with KwikRewards Tokens?
They are used as credits in the KwikRewards Portal.
What happens after I claim rewards in the KwikRewards Portal?
You will receive the actual rewards vouchers which you may use in our partners’ websites, apps, and establishments.
Are KwikRewards Tokens transferrable?
Yes, they may be transferred as long as they are not yet claimed/exchanged in the KwikRewards Portal.
Are partners’ rewards vouchers transferrable?
This depends on our partners’ terms and conditions. It is best to check first before exchanging your credits for the vouchers.
When do KwikRewards Tokens and Credits expire?
They will expire on May 31, 2026.
When will Partners’ Rewards Vouchers expire?
This depends on Partners’ Terms and Conditions upon claiming of voucher.
What happens if I don’t disclose one of the conditions listed in the form?
In the event that an applicant did not declare mentioned illnesses reflected in our medical declaration form, coverage will be denied at point of availment
What if I have one of the listed conditions but not the combination of more than three?
The corresponding plan premium for each member will depend on the declared condition.
What if I have a pre-existing condition that is not listed in the new form?
All other pre-existing conditions will be covered after six (6) months of continuous subscription, up to 50% of the MBL.
For renewing members, PEC is covered up to MBL from 2nd year onwards.
What happens when my plan is renewed?
Starting January 22, 2025, all new applications and annual renewal will have the following minor benefit modification:
(1) Pre-Existing Condition (PEC)
Summary
Item
Premium
Basic Premium
Premium Tax/VAT
Gross Premium
₱ 1,495.00
* Kindly see Important Notes section