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Want to have Intellicare as your healthcare provider? Click HERE
Health Maintenance Organization

Under Intellicare’s HMO Program, corporate clients gain access to Intellicare’s nationwide network of medical providers based on a fixed and periodic payment agreed upon by both companies. Clients under the HMO Program have dedicated Account Officers who handle all queries and concerns raised by the members, as well as Wellness Programs catered to their current health-related needs and wants.

Who is eligible to enroll?

  • Single Proprietor/Partnership/Corporation duly registered with DTI or SEC to conduct business in the Philippines.
  • Minimum of 10 regular employees.

Membership Eligibility

  1. Principal members – eligible employees (as determined by the enrolling company) aged 18 and not more than 65 years old
  2. Dependents:
    1. For married principals:
      • Legal spouse, not more than 65 years old
      • Children – legitimate, legally adopted or legitimated; unmarried, unemployed, wholly dependent financially on the Principal member; not more than 21 years old
    2. For single/unmarried principals:
      • Biological children – unmarried, unemployed, not more than 21 years old
      • Parents – not more than 65 years old
      • Siblings – unmarried, unemployed, wholly dependent financially on the Principal member; not more than 21 years old

What are the benefits in enrolling under the HMO Program?

  • Intellicare members have the privilege to avail of the following services at any accredited hospitals and clinics nationwide.
    1. ANNUAL PHYSICAL EXAM
      • Complete blood count
      • Physical examination
      • Urinalysis
      • Fecalysis
      • Chest x-ray
      • Electrocardiogram (for members age thirty-five (35) years and above, or if indicated/prescribed)
      • Pap smear (for female members age thirty-five (35) years and above, or if indicated/prescribed)
    2. PREVENTIVE CARE
      • Periodic medical check-up
      • Management of health problems
      • Counseling on health habits (e.g. family planning, diet prescriptions)
      • Record keeping of medical history
      • Routine Immunization (except cost of vaccines)
    3. OUT-PATIENT
      • Medical consultation during regular clinic hours, excluding prescribed medicines
      • Emergency room care
      • Referral to affiliated specialist/s
      • Eye, ear, nose, and throat consultations
      • Treatment of minor injuries and/or illnesses
      • Laboratory tests, x-rays, and other diagnostic exams prescribed by the Intellicare physician
      • Minor surgery not requiring confinement
      • Speech and physical therapy
      • Pre-natal and post-natal consultations
    4. IN-PATIENT CONFINEMENT
      • No deposit upon admission
      • Room and board benefits specified in contract
      • Use of operating room and recovery room facilities
      • Standard admission kit (e.g. ID bracelet, thermometer)
      • Professional services of all attending affiliated specialists and/or anesthesiologists
      • Anesthesia and medications
      • Blood transfusions and intravenous fluids
      • Laboratory tests, x-rays, and other diagnostic examinations
      • Administered medicines
      • Dressings, plaster casts, sutures, and other items directly related to the medical management of the patient
      • ICU confinement/dialysis
      • CT scan and ultrasound (except for maternity cases)
      • Ambulance service
      • All other hospital charges deemed necessary by the Intellicare-affiliated physician in the treatment of the patient
    5. EMERGENCY CARE
      1. IN ACCREDITED HOSPITALS
        • Doctor’s services
        • Medicines used
        • Oxygen and intravenous fluids
        • Dressings, casts, and sutures
        • Laboratory, x-ray, and other diagnostic examinations directly related to the emergency management of the patient
      2. IN NON-ACCREDITED HOSPITALS
        • Intellicare agrees to reimburse up to eighty percent (80%) of the total hospital bills including professional fees using the Intellicare Relative Values Scale (RVS) but not to exceed Php 30,000.00.
      3. IN FOREIGN COUNTRIES
        • Confinement in foreign territory shall be treated as if the member had been confined in a non-accredited hospital facility using the Intellicare Relative Values Scale (RVS) but not to exceed Php 30,000.00.
      4. IN AREAS WITHOUT ACCREDITED HOSPITALS
        • Intellicare agrees to reimburse up to one hundred percent (100%) of the total hospital bills including professional fees using the Intellicare Relative Values Scale (RVS) but not to exceed Php 30,000.00.
    6. FINANCIAL ASSISTANCE INCLUDING ACCIDENTIAL DEATH AND DISMEMBERMENT (for principal members only)
      • ♦  Natural death Php 10,000.00
        ♦  Accidental death Php 20,000.00
        ♦  Loss of both hands Php 10,000.00
        ♦  Loss of both feet Php 10,000.00
        ♦  Loss of sight of both eyes Php 10,000.00
        ♦  Loss of one hand and one foot Php 10,000.00
        ♦  Loss of one hand and sight of one eye Php 10,000.00
        ♦  Loss of one foot and sight of one eye Php 10,000.00
        ♦  Loss of one hand or one foot Php 5,000.00
        ♦  Loss of sight of one eye Php 5,000.00
    7. OPTIONAL BENEFIT (Dental Services)
      • Dental examination
      • Annual oral prophylaxis
      • Oral health education through chairside instruction
      • Orthodontic consultation (braces and malposition of teeth)
      • Pre-natal check of teeth and gums
      • Temporo Mandibular Joint (TMJ) consultation (clicking of jaws)
      • Conduct activities on dental health education (e.g. regarding AIDS)
      • Emergency dental treatment for the relief of pain
      • Gum treatment for cases like inflammation or bleeding
      • Temporary fillings
      • Simple extraction of unsavable tooth
      • Recementation of fixed bridges, crowns, jackets, inlays/outlays

How can we get a quotation and enroll in the HMO Program?

  • As of the moment, Intellicare only accepts requests for proposals for CORPORATE ACCOUNTS. Should you wish have Intellicare as your healthcare provider, click HERE