Maxicare PRIMA Silver
• Unlimited lab tests, diagnostics and consultations for individuals 0 to 59 years old
Highlights
• Unlimited prescribed lab tests and diagnostics
• Unlimited consultations
• Valid at any Maxicare Primary Care Clinics (PCC)
• Single usage per type of dental service
• Eligible for newborns to 59 years only
• Valid for 1 year from activation date
• Covers preexisting conditions
• No preliminary checkup and paperwork needed
Coverage
• Any life-threatening or unexpected onset of a condition or illness, which requires the immediate alleviation of pain or discomfort within 24 hours including confinement in a regular private room.
Includes
Consultation and Diagnostics
• Ear-Nose-Throat (ENT)
• Medical Dermatologist
• Internal Medicine (IM)
• Obstetrician-Gynecologist (OB-GYN)
• Ophthalmologist
• Pediatrician
• Laboratory and diagnostic Procedures (as prescribed by a Maxicare-affiliated physician)
*Consultation and prescribed laboratory and diagnostic out-patient procedures are only available at Maxicare Primary Care Clinics
Dental Service
• FREE Dental Care Services with MetroDental (once within a year)
• Mild oral prophylaxis (cleaning)
• Full mouth panoramic X-Ray
• Dental consultation
• Emergency relief of dental pain through medication
• Cosmetic or oral rehab treatment planning
• Dental nutrition and counseling
• Dental health education
• Preparation of dental certificates
• Safekeeping of dental records as required by law or client
• Fluoride gel
Teleconsult
• Access to Maxicare Telemedicine 24/7 Teleconsult Voice Call at (02) 8582-1980
Videoconsult
• Access to Maxicare Videoconsult powered by Doctor Anywhere (available once promo codes have been sent via email)
Excludes
• Hospital admission or confinement
• Emergency care coverage
Exclusions and Limitations
1.Services obtained for emergency conditions from non-affiliated physicians and hospitals
2.Injuries, infections or conditions resulting from:
-negligence
-alcoholic liquor intake
-unauthorized use of prohibited drugs or regulated drugs
-violation of law or ordinance or unnecessary exposure to imminent danger,
-direct or indirect participation in the commission of crime,
-direct participation in riots, strikes, and other civil disturbances,-
-war or any combat-related activities while in military service-,
-extreme sports,
-developmental disorders,
-circumcision and sex transformation,
-tattoos,
-body piercing,
-attempted suicide,
-acupuncture,
-congenital, genetic and hereditary conditions,
-chronic dermatoses
3. HIV and AIDS-related diseases, sexually transmitted diseases
4. All pregnancy and maternity-related conditions
5. Epidemic or pandemic infectious diseases
6. Psychiatric and/or psychological disorders
7. Aesthetic, cosmetic and reconstructive surgery
8. Oral surgery and dental treatments
9. All types of vaccines except for animal bites vaccine administration
10. Pregnancy test
11. Take-home medicines
12. Medico-legal fees
13. Ambulance service
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