Medical allowance for government employees

All-In protection against sudden medical emergencies. ER Care All-In provides up to P100,000 worth of outpatient (ER treatment) and inpatient (confinement) care coverage on emergency cases due to accidents, viral/bacterial diseases, and specific conditions. Kids from 1 to 17 years old and adults from 18 to 64 years old can take advantage of this one-time use health plan. 

The benefit limit covers:   

• Doctor’s professional fee 
• Emergency room treatment 
• Laboratory and diagnostic procedures 
• Room accommodation if confinement is required 
• Required medicines during hospitalization 
• Surgery and surgeon’s fees, if medically required 
• Surgery and surgeon’s fees when medically necessary 
• Use of operating room, recovery room, and ICU, as medically necessary 
• Special modalities of treatment as medically required in emergency room care and confinement, and subject to Php 5,000 standard limit. 
• Hospital cash allowance of Php 1,000 when confined (for adults only) 
• 1-year unlimited access to telemedicine/remote medical consultation (for kids only) 

ER Care All-In is valid for 1 year or up until used, whichever comes first. It can be used in more than 2,000 IHC-accredited hospitals in the Philippines, excluding the Top 6 hospitals in Metro Manila namely Asian Hospital and Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center (QC and BGC), The Medical City. 

ER Care All-In covers diseases that include, but are not limited to:

• Acute Bronchitis
• Acute gastroenteritis with dehydration
• Acute tonsillopharyngitis with moderate dehydration
• Acute Sinusitis
• Acute tonsillopharyngitis
• Acute Upper Respiratory Tract Infection
• Amoebiasis
• Cellulitis
• Dengue Fever
• Acute Pneumonia
• Typhoid Fever
• Urinary Tract Infection
• SVI (systemic viral infection) with fever
• Measles with high-grade fever
• Chicken pox with complications
• Leptospirosis
• Polio
• Cholera
• Diphtheria
• Pertussis
• Tetanus
• Rabies
• Meningitis
• Chikungunya
• Malaria
• Anaphylactic Shock
• Acute Appendicitis

ER Care All-In covers accidents that include, but are not limited to:

• Accidents, excluding Cerebrovascular (Stroke)
• Fracture, new
• Burns, new
• New animal bites, including first dose of vaccines up to a maximum of Php20,000
• Cuts, new, needing suturing
• Sports injuries, contact and noncontact sports, excluding professional sports and high-risk sports

A Member’s eligibility to emergency care benefits under the Agreement shall be based on the final medical diagnosis.

NON-COVERABLE CONDITIONS

Non-emergency and pre-existing conditions, congenital and maternity-related conditions, and other conditions under IHC’s General Exclusions list are not covered by this product.

An illness or condition is considered pre-existing if, prior to effective date of coverage:

1. Any professional advice or treatment was given for such illness or condition;
2. Such illness or condition was in any way already known to the Member; or
3. The pathogenesis of such illness or condition had already started (of which the Member may not be aware of).

Non-coverable accidents include, but are not limited to: self-inflicted injuries; injuries from professional sports and high-risk sports; injuries or illnesses due to military, paramilitary, or police service; injuries from high risk activities or suffered under conditions of war; and accidents that are secondary to or contracted due to degenerative diseases such as Alzheimer’s Disease and Parkinson’s Disease.

1. What does ER Care All-In 100 Adults cover? With a Php 100,000 benefit limit, ER Care All-In 100 Adults covers emergency cases due to accidents and viral and bacterial illnesses. It covers expenses on outpatient and inpatient emergency care, room and board, diagnostic procedures as medically necessary during confinement, medicines as medically necessary during confinement, use of operating room, recovery room, and ICU diagnostic procedures, as medically necessary.
2. What are considered emergency cases and accidents? An emergency case is a sudden, unexpected onset of illness or injury having the potential of causing immediate disability or death, or requires the immediate alleviation of severe pain and discomfort.

Accident means a visible, external, sudden and violent event occasioned by a physical or natural cause and occurring entirely beyond the Members’ control causing damage to the health of the Member.

ER Care All-In 100 Adults covers accidents that include, but are not limited to: ● Accidents, excluding Cerebrovascular (Stroke) ● Fracture, new ● Burns, new ● New animal bites, including first dose of vaccines ● Cuts, new, needing suturing ● Sports injuries, contact and noncontact sports, excluding professional sports and high-risk sports ● Accidental chemical poisoning

ER Care All-In 100 Adults covers diseases that include, but are not limited to: ● Acute Bronchitis ● Acute gastroenteritis with dehydration ● Acute tonsillopharyngitis with moderate dehydration ● Acute Sinusitis ● Acute tonsillopharyngitis ● Acute Upper Respiratory Tract Infection ● Amoebiasis ● Cellulitis ● Dengue Fever ● Acute Pneumonia ● Typhoid Fever ● Urinary Tract Infection ● SVI (systemic viral infection) with fever ● Measles with high-grade fever ● Chicken pox with complications ● Leptospirosis ● Polio ● Cholera ● Diphtheria ● Pertussis ● Tetanus ● Rabies ● Meningitis ● Chikungunya ● Malaria ● Anaphylactic Shock ● Acute Appendicitis ● Acute Gastritis

A Member’s eligibility to emergency care benefits under the Agreement shall be based on the final medical diagnosis.

1. Who is qualified for ER Care All-In 100 Adults? Adults, 18 to 64 years old, can get ER Care All-In 100 Adults and register as a Member. Upon purchase, you can register online at www.insularhealthcare.com.ph/registerproduct
2. When can I start using ER Care All-In 100 Adults? From the day you register (“registration date”), the health voucher will be activated after ten (10) calendar days. Your health voucher is valid for 12 months or up until used.Example: Registration date is Day 0. If you register on August 1, your health voucher will be activated on August 12. It will then be valid from August 12, 2018 to August 11, 2019 or up until used.
3. How many times can I register ER Care All-In 100 Adults in my name? If you have already used your ER Care All-In 100 Adults health voucher, you can get another ER Care All-In 100 Adults to be covered again. Note that a person can only be covered by one (1) product offering emergency care benefits at any point in time.
4. If the benefit limit is not be wholly consumed, can I use the health voucher again in the future? ER Care All-In 100 Adults is for one-time use only, regardless if the total annual benefit limit is consumed or not. The advantage of this health voucher is its high benefit limit, affordability, and convenient registration process. It assures you of assistance for most or all expenses you incur for outpatient emergency care, and allows you to avail and register another one to renew your coverage.
5. Is PhilHealth coverage needed to use ER Care All-In 100 Adults? Yes. Once there is an admission, PhilHealth coverage is required since it also covers inpatient care. However, for those who do not have PhilHealth coverage, one may just pay the PhilHealth portion of the hospital bill before discharge.
6. If I already have an existing Insular Health Care plan with emergency care benefits, can I still register for ER Care All-In 100 Adults? No. You cannot register for ER Care All-In 100 Adults if you are already enrolled in IHC’s other health care programs with emergency care coverage, even if your total benefit limit has already been consumed.
7. Can I register an ER Care All-In 100 Adults health voucher for someone else? Yes, as long as you know the personal data of the individual and obtained his/her authorization to be registered. We have ER Care prepaid health vouchers that can be given as gifts to your loved ones. The data required for registration are as follows: a. Full name b. Birth date c. Home address d. Email address e. Mobile number
8. Can I transfer ER Care All-In 100 Adults to another person? ER Care All-In 100 Adults is transferable as long as it has not yet been registered. This also lets you purchase the health vouchers as gifts.
9. Can I use ER Care All-In 100 Adults in hospitals not on the health voucher’s provider list? No. Services can only be availed in IHC-accredited hospitals and clinics. Check Our Partners to see the list of IHC-accredited hospitals.
10. What conditions are not covered by ER Care All-In 100 Adults? Non-emergency and pre-existing conditions, congenital and maternity-related conditions, and other conditions under IHC’s General Exclusions list are not covered by this product.

An illness or condition is considered pre-existing if, prior to effective date of coverage: (a) Any professional advice or treatment was given for such illness or condition; (b) Such illness or condition was in any way already known to the Member; or (c) The pathogenesis of such illness or condition had already started (of which the Member may not be aware of).

Non-coverable accidents include, but are not limited to: self-inflicted injuries; injuries from professional sports and high-risk sports; injuries or illnesses due to military, paramilitary, or police service; injuries from high risk activities or suffered under conditions of war; and accidents that are secondary to or contracted due to degenerative diseases such as Alzheimer’s Disease and Parkinson’s Disease.

For more information, see “General Exclusions”.