Your Guide
Your Membership Card



Your membership card serves as the valuable link that informs PhilamCare staff to the extent of your coverage. It verifies who you are, what you are entitled to and when you are covered. We request that you have these cards at all times upon using any PhilamCare facility . If there had been an error in the information of your membership cards, kindly inform your agent or call us and we will be happy to replace it for you at no extra charge. However, if you have lost the card, we will be required to charge you a small replacement fee.

.. may be composed of an Identification Card and Data Card. For some members in group accounts, the Identification Card may not be required. We request that you consult your local HRD manager to confirm your requirements.

 

I. BASIC IDENTIFICATION CARD




A. NAME OF MEMBER
B. AGREEMENT NO. - Member's agreement number
C. BIRTHDATE OF MEMBER
D. ORIGINAL EFFECTIVE DATE - date when member was first covered
E. CONTRACT YEAR - Period of coverage for the year
F. ROOM & BOARD LIMIT - Room Classification & Daily Room & Board limit for affiliated hospital. Ex: PR 1050, PR stands for private, the room classification to which the member is entitled. For semi-private, the code is SP while for ward the code is W. 1050 is the maximum daily cost for room & board. The patient pays any amount in excess of this maximum daily limit in case of confinement.
G. MAXIMUM LIMIT - Maximum limit that PhilamCare will cover for dreaded disease and/or confinement per disability.
H. COVERAGE TYPE - Member's coverage
I. EXCLUSION - Code for specific illness/es which have been excluded for the member's coverage, if any (Please refer to your agreement to see if you have any specific exclusion).



A. PHILHEALTH - Philhealth is required
B. DENTAL CLINIC - Codes which indicate member's dental clinic assignment, if applicable.
C. HOSPITAL(S) - Indicates if member can avail services at Makati Medical Center or not
D. POINT OF SERVICE (POS) - (Refer to Point-of -Service option in the guidebook.)
E. PRE-EXISTING CONDITIONS - Indicates whether pre-existing condition is waived
F. OUT-PATIENT EMERGENCY ROOM - Indicates whether out-patient emergency room service is included in the members plan
G. ANNUAL PHYSICAL EXAMINATION - type of annual physical examination covered
H. MATERNITY BENEFITS - Indicates whether maternity benefits is included in member's coverage
I. MEDICINE(S) - Indicates whether member's coverage includes out-patient medicines
J. OTHERS – Indicates member’s exclusions
K. PHILAMCARE EMERGENCY HOTLINE - telephone number of PhilamCare Emergency Hotline
L. Control Number
M. CARDHOLDER'S SIGNATURE - member's signature

 




Remember: Your ID card is for identification only. This card does not guarantee
your entitlement to benefits. Such entitlement is defined solely by your contract of
Health Care Agreement.